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Rearranging Everyday Lives among People with Type 2 Diabetes in Korea

  • Yi, Myungsun;Koh, Moonhee;Son, Haeng-Mi
    • Korean Journal of Adult Nursing
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    • v.26 no.6
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    • pp.703-711
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    • 2014
  • Purpose: The purpose of the study was to understand what are the experiences and management of type 2 diabetes in everyday lives among Korean people. Methods: A grounded theory method was utilized to explore how people with type 2 diabetes to experience and manage their disease under the Korean socio-cultural context. The data were collected via narrative in-depth interviews with 21 people with type 2 diabetes during 2010-2011 and all interviews were transcribed for verbatim analysis. Results: The core category was 'Rearranging everyday lives by accepting diabetes as lifelong annoying companion.' Four stages were identified: ignoring; struggling compromising and conciliating. Each stage illustrates major problems and/or strategies that the participants face in dealing with diabetes. The process illustrates the transference from their ordinary life, in which diabetes or health was ignored, to the health-oriented life, within which diabetes is integrated into their lives. The most difficult barriers they faced in everyday lives include social stigma of diabetes and collectivistic culture in Korea. Within the culture, the group goals are concerned over individual ones, making it harder for the participants to take care of their own health. Conclusion: The findings of the study imply that health care professionals may consider the influence of social stigma in caring diabetic patients. Also, the intervention study is warranted to educate Korean people with diabetes to get aware of the sociocultural context and stigma as well as personal difficulties in self-caring diabetes.

Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status

  • Kim, Bo-Yeon;Won, Jong Chul;Lee, Jae Hyuk;Kim, Hun-Sung;Park, Jung Hwan;Ha, Kyoung Hwa;Won, Kyu Chang;Kim, Dae Jung;Park, Kyong Soo
    • Diabetes and Metabolism Journal
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    • v.43 no.4
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    • pp.487-494
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    • 2019
  • Background: The objective of this study was to investigate the prevalence, management, and comorbidities of diabetes among Korean adults aged 30 years and older. Methods: This study used 2013 to 2016 data from the Korea National Health and Nutrition Examination Survey, a nationally-representative survey of the Korean population. Diabetes was defined as fasting glucose ≥126 mg/dL, current use of antidiabetic medication, a previous history of diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%. Results: In 2016, 14.4% (approximately 5.02 million) of Korean adults had diabetes. The prevalence of impaired fasting glucose was 25.3% (8.71 million). From 2013 to 2016, the awareness, control, and treatment rates for diabetes were 62.6%, 56.7%, and 25.1%, respectively. People with diabetes had the following comorbidities: obesity (50.4%), abdominal obesity (47.8%), hypertension (55.3%), and hypercholesterolemia (34.9%). The 25.1%, 68.4%, and 44.2% of people with diabetes achieved HbA1c <6.5%, blood pressure <140/85 mm Hg, and low density lipoprotein cholesterol <100 mg/dL. Only 8.4% of people with diabetes had good control of all three targets. Conclusion: This study confirms that diabetes is as an important public health problem. Efforts should be made to increase awareness, detection, and comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.

Interaction Effects between Individual Socioeconomic Status and Regional Deprivation on Onset of Diabetes Complication and Diabetes-Related Hospitalization among Type 2 Diabetes Patients: National Health Insurance Cohort Sample Data from 2002 to 2013 (개인의 사회경제적 수준과 지역의 사회경제적 수준의 상호작용이 제2형 당뇨 환자에서 당뇨합병증 발생 및 당뇨와 관련된 입원에 미치는 영향: 2002-2013년 국민건강보험공단 표본 코호트 자료를 활용하여)

  • Jang, Jieun;Ju, Yeong Jun;Lee, Doo Woong;Lee, Sang Ah;Oh, Sarah Soyeon;Choi, Dong-Woo;Lee, Hyeon Ji;Shin, Jaeyong
    • Health Policy and Management
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    • v.31 no.1
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    • pp.114-124
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    • 2021
  • Background: In this study, we aimed to investigate the interaction effects of individual socioeconomic status and regional deprivation on the onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients. Methods: Korean National Health Insurance Service National Sample Cohort data from 2002 to 2013 were used. A total of 50,954 patients newly diagnosed with type 2 diabetes from 2004 to 2012 and aged 30 years or above were included. We classified patients into six groups according to individual income level and neighborhood deprivation: 'high in advantaged,' 'high in disadvantaged,' 'middle in advantaged,' 'middle in disadvantaged,' 'low in advantaged,' and 'low in disadvantaged.' We calculated hazard ratios (HR) of onset of diabetes complication and diabetes-related hospitalization using the Cox proportional hazard model, with the reference group as diabetes patients with high income in advantaged regions. Results: In terms of the interaction effects of individual income level and regional socioeconomic level, even with the same low individual income level, the group with a high regional socioeconomic level (low in advantaged) showed low HRs for the onset of diabetes complication (HR, 1.04; 95% confidence interval [CI], 1.00-1.08) compared to the 'low in disadvantaged' group (HR, 1.10; 95% CI, 1.05-1.16). In addition, the 'high in advantaged' group showed slightly higher HRs for the onset of diabetes complication (HR, 1.06; 95% CI, 1.00-1.11) compared to the 'low in advantaged' and it appeared to be associated with slight mitigation of the risk of diabetes complication. For the low-income level, the patients in disadvantaged regions showed the highest HRs for diabetes-related hospitalization (HR, 1.29; 95% CI, 1.19-1.41) compared to the other groups. Conclusion: Although we need to perform further investigations to reveal the mechanisms that led to our results, interaction effects individual socioeconomic status and regional deprivation might be associated with on onset of diabetes complications and diabetes-related hospitalization among type 2 diabetes patients.

Adiponectin Level in Non-Pregnant Women, Pregnant Women without Diabetes and Pregnant Women with Diabetes

  • Jo, Yoon-Kyung;Im, Jee-Aee
    • Biomedical Science Letters
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    • v.14 no.4
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    • pp.233-238
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    • 2008
  • Gestational diabetes mellitus (GDM) is a common complication during pregnancy and one of the main causes of adverse fetal-maternal outcomes. However, the pathogenesis of GDM has not been clearly stated. Adiponectin, an adipose tissue-derived plasma protein, is involved in regulation of insulin resistance and glucose hemostasis, and thus is a key modulator of insulin action and glucose metabolism. In this study, we investigated to compare serum adiponectin levels in pregnant women with diabetes, pregnant women who are without diabetes, and non-pregnant women, and to evaluate relationship between serum adiponectin. levels and metabolic parameters. Forty-one pregnant women with diabetes, fifty-nine pregnant women without diabetes and forty non-pregnancy women were recruited. Adiponectin levels were significantly lower in pregnant women with diabetes when compared to non-pregnant women and pregnant women without diabetes. Pregnant women without diabetes at second trimester had lower adiponectin levels compared to non-pregnant women. Adiponectin was negatively correlated with BMI, fasting insulin, HOMA-IR, total cholesterol, and triglyceride. In conclusion, this study confirmed that the decreased level of adiponectin precedes the onset of abnormal glucose level during pregnancy and also normal pregnant women had lower adiponectin levels compared to non-pregnant women. This knowledge may help to identify strategies for lowering the occurrence of GDM in women who are at high risk of developing the disorder.

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Comparison of Dietary Intakes and Plasma Lipid Levels in Diabetes and Control Elderly (당뇨병 노인군과 대조군의 영양소 섭취실태 및 혈장지질 양상비교)

  • 이상은;김정희
    • Korean Journal of Community Nutrition
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    • v.9 no.1
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    • pp.98-112
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    • 2004
  • This study was done to investigate and compare the nutritional status and plasma lipids in the diabetes and control elderly. Subjects were 105 persons (male 32, female 73) aged over 65 years and visited public health centers in Ulsan area. The subjects were divided into 2 groups, diabetes and control group. Athropometric measurement, dietary intakes, and plasma biochemical indices were examined. Body Mass Index (BMI), Percentage of Ideal Body Weight (PIBW) and Waist-Hip Ratio (WHR) of diabetes group were higher than those of control group. Overall eating behavior were worse in diabetes group than those of control group. There was no significant difference in smoking and exercise status among groups. The ratio of drinkers was significantly higher in control group. But the amount of alcohol consumed at once was higher in the diabetes group. There was no significant difference in most nutrient intakes between males and females. The intakes of fiber, natrium (Na), vitamin A, and $\beta$-carotene were significantly higher in diabetes group than control groups while that of potassium (K) was lower in diabetes group. Diabetes group had the higher levels in triglyceride, VLDL-cholesterol, Chol/HDL-cholesterol ratio, LDL/HDL-cholesterol ratio, while they had lower HDL-cholesterol level. Overall results might imply that the elderly with diabetes have to be more careful to their meals and health-related behaviors to increase the likelihood of a healthier life.

The Effect of a Community-Based Selp-Help Management Program for Patients with Diabetes Mellitus (당뇨병 환자를 위한 지역사회 중심 자조관리 프로그램의 효과)

  • Kim, Eun-Young;So, Ae-Young
    • Journal of Korean Academy of Community Health Nursing
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    • v.20 no.3
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    • pp.307-315
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    • 2009
  • Purpose: This study was done to assess the effects of a self-help intervention on clinical, lifestyle and psycho-social outcomes in patients with Type II diabetes. Methods: Eligible adults with Type II diabetes were randomly assigned to either the intervention group receiving the diabetes self-help or the control group receiving usual care. Of the 36 patients who completed the study, 15 were in the intervention group and 21 were in the control group. The self-help group consisted of six weekly sessions covering aspects of diabetes self-care and using continuing education, discussion, and structured social activities. Outcomes included changes in glycemic control, knowledge, self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. Analysis of covariance was used to compare outcomes between the groups, adjusting for baseline measures. Results: After the six week intervention, significant improvements from the baseline were observed in the measurements of self-management behaviors, diabetes-related self-efficacy, and health-related quality of life for the intervention group. Conclusion: The findings provide preliminary evidence that a diabetes self-help group intervention can benefit diabetes patients in self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. However, larger longitudinal studies are needed to determine the most efficacious self-management methods to sustain long-term glycemic control and psychological well-being.

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A study on the measuring health literacy in patients with diabetes in Korea (당뇨병 환자의 건강정보이해능력 측정을 위한 기초 연구)

  • Kang, Soo Jin;Sim, Kang Hee;Chang, Soo Jung;Lee, Mi Sook
    • Korean Journal of Health Education and Promotion
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    • v.33 no.5
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    • pp.47-57
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    • 2016
  • Objectives: To develop and evaluate the applicability of a health literacy instrument in patients with diabetes by measuring their ability to understand diabetes-related words. Methods: Diabetes-related words were extracted from the Korean Diabetes Association's website and literature reviews. In the first phase, three nursing researchers evaluated 2,661 diabetes-related words based on graded lexical vocabularies and what patients need to know about self-care, and the narrowed them to 255 words. In the second phase, a content validity assessment was conducted by an expert panel. In the third phase, the remaining 25 words were administered to 200 conscientious with type 2 patients aged 40 years old and using a Gallup survey from March 3 to 17, 2016 in Seoul, Korea. Descriptive analysis and Rasch analysis were performed to test psychometric properties. Results: The mean score was 21.47 with a range of 0 to 25. The Cronbach's ${\alpha}$ was .92. The health literacy instrument using diabetes-related words had a ceiling effect response. Conclusions: Diabetes-related words are useful and reliable items for testing the health literacy of diabetes patients. Future study is needed to develop and validate health literacy measures for diabetic patients.

Metabolic Consequences of Obstructive Sleep Apnea Especially Pertaining to Diabetes Mellitus and Insulin Sensitivity

  • Song, Sun Ok;He, Ken;Narla, Radhika R.;Kang, Hyun Goo;Ryu, Han Uk;Boyko, Edward J.
    • Diabetes and Metabolism Journal
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    • v.43 no.2
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    • pp.144-155
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    • 2019
  • Obstructive sleep apnea (OSA) and diabetes has been known to be closely related to each other and both diseases impact highly on the public health. There are many evidence of reports that OSA is associated with diabetes with a bidirectional correlation. A possible causal mechanism of OSA to diabetes is intermittent hypoxemia and diabetes to OSA is microvascular complication. However, OSA and diabetes have a high prevalence rate in public and shares the common overlap characteristic and risk factors such as age, obesity, and metabolic syndrome that make it difficult to establish the exact pathophysiologic mechanism between them. In addition, studies demonstrating that treatment of OSA may help prevent diabetes or improve glycemic control have not shown convincing result but have become a great field of interest research. This review outlines the bidirectional correlation between OSA and diabetes and explore the pathophysiologic mechanisms by approaching their basic etiologies.

Nonalcoholic Fatty Liver Disease in Diabetes. Part I: Epidemiology and Diagnosis

  • Lee, Yong-ho;Cho, Yongin;Lee, Byung-Wan;Park, Cheol-Young;Lee, Dae Ho;Cha, Bong-Soo;Rhee, Eun-Jung
    • Diabetes and Metabolism Journal
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    • v.43 no.1
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    • pp.31-45
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    • 2019
  • Nonalcoholic fatty liver disease (NAFLD) and diabetes are common metabolic disorders whose prevalence rates are expected to rise worldwide, corresponding to aging and increasingly obese populations. Compared to the general population (around 25%), 50% to 70% of people with diabetes have NAFLD, and NAFLD severity (including fibrosis) tends to be worsened by the presence of diabetes. NAFLD is considered an emerging risk factor for type 2 diabetes mellitus and a contributor to the development of chronic diabetes-related complications. This reciprocal relationship demonstrates the importance of confirming suspected NAFLD in patients with diabetes. Due to the invasive nature of liver biopsy to assess NAFLD status, various alternative non-invasive modalities have been developed and validated. Here, we summarized the epidemiology of NAFLD in patients with diabetes and reviewed currently available imaging modalities and biomarker-based prediction models for their ability to detect liver steatosis and/or fibrosis.

Factors Influencing Diabetes Educational Needs in Patients with Diabetes Mellitus (당뇨병환자의 교육요구도 영향요인)

  • Park, Seon-Yeong;Oh, Pok-Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.7
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    • pp.4301-4309
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    • 2014
  • This study was carried out to identify the perceived educational needs of diabetes mellitus type 2(DM 2) patients and the factors influencing their diabetes educational needs. The descriptive and correlation study design was used. The data was collected from January 2, 2012 to February 29 10, 2012 and a total of 346 diabetes patients responded in a structured instrument regarding their characteristics, diabetes knowledge and needs for diabetes education. The data was analyzed using ANOVA, t-test, Scheffe test, Pearson correlation, and stepwise multiple regression. The mean score of the diabetes educational needs was 3.03 (range: 1.09-4.00). Of the factors significantly influencing the diabetes educational needs, age (${\beta}$=-.25, p<.001), diabetes education participation of the family (${\beta}$=.21, p=.003), and self blood sugar test (${\beta}$=-.13, p=.045) explained the 11% variance of the diabetes educational needs. These three factors need to be considered when implementing diabetes education programs for diabetes management.