Advances in Continuous Glucose Monitoring and Integrated Devices for Management of Diabetes with Insulin-Based Therapy: Improvement in Glycemic Control

유지희,김재현 대한당뇨병학회 2023 Diabetes and Metabolism Journal Vol.47 No.1

Continuous glucose monitoring (CGM) technology has evolved over the past decade with the integration of various devices including insulin pumps, connected insulin pens (CIPs), automated insulin delivery (AID) systems, and virtual platforms. CGM has shown consistent benefits in glycemic outcomes in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) treated with insulin. Moreover, the combined effect of CGM and education have been shown to improve glycemic outcomes more than CGM alone. Now a CIP is the expected future technology that does not need to be worn all day like insulin pumps and helps to calculate insulin doses with a built-in bolus calculator. Although only a few clinical trials have assessed the effectiveness of CIPs, they consistently show benefits in glycemic outcomes by reducing missed doses of insulin and improving problematic adherence. AID systems and virtual platforms made it possible to achieve target glycosylated hemoglobin in diabetes while minimizing hypoglycemia, which has always been challenging in T1DM. Now fully automatic AID systems and tools for diabetes decisions based on artificial intelligence are in development. These advances in technology could reduce the burden associated with insulin treatment for diabetes.

다문화 청소년의 우울경험과 관련요인 : 일반청소년과의 비교

유지희,황숙연 이화여자대학교 사회복지전문대학원 사회복지연구소 2016 사회복지 실천과 연구 Vol.13 No.1

본 연구의 목적은 다문화가정 청소년의 우울에 영향을 미치는 요인을 인구사회학적 요인과 건강행태요인을 중심으로 검토하고 이를 일반청소년의 경우와 비교하는 것이다. 본 연구는 질병관리본부가 실시한 2015년 제 11차 건강행태온라인조사의 원시자료를 사용하여 SPSS 21.0을 이용하여 분석하였다. 연구의 대상자는 총 68,111명으로 일반청소년은 67,316명, 다문화청소년은 795명이었다. 두 집단의 우울에 영향을 미치는 요인을 로지스틱 회귀 분석한 결과에 따르면 일반청소년은 변수의 모든 요인이 우울에 유의미한 영향력을 미치는 반면, 다문화청소년은 여학생일수록, 행복감이 낮을수록, 스트레스가 높을수록, 흡연을 할수록, 그리고 폭력경험이 많을수록 우울한 것으로 나타났다. 이와 같은 연구결과를 통해 다문화 청소년의 우울에 대한 접근과 개입전략의 초점이 논의되었다. 다문화청소년의 경우에는 여학생 및 흡연경험자에 대한 좀 더 적극적인 우울 스크리닝과 스트레스를 감소시킬 수 있는 프로그램이 필요하며, 무엇보다 학교폭력 문제에 대한 면밀한 모니터링과 추후관리가 필요함을 시사한다. The aims of this study are to examine factors influencing depression among adolescents from multi-cultural families in Korea and compare them with those from general families. Socio-demographic and health behavior variables were included in the analysis. The data were derived from the 15th Korea Youth Risk Behavior Web-based Survey 2015 in Korea and analyzed using the IBM SPSS statistics version 20.0 software package. The subject were 68,111 Korean adolescents (general youth 67,316, multi-cultural youth 794). The logistic regression analysis found the following results; most socio-demographic and health behavior factors had effect on depression among general youth, while only gender, happiness, stress, smoking and school violence had significant effect on that among multicultural youth. Based on these results, the focus of approach and intervention strategy to address depression among multicultural youth were discussed. More proactive depression screening and program to reduce stress might be needed. Most of all, close monitoring for school violence and follow-up was suggested.

The Prevalence of Peripheral Arterial Disease in Korean Patients with Type 2 Diabetes Mellitus Attending a University Hospital

유지희,황윤우,신미선,정창희,김은희,이상아,고은희,이우제,김민선,박중열,이기업 대한당뇨병학회 2011 Diabetes and Metabolism Journal Vol.35 No.5

Background: Peripheral arterial disease (PAD) is a common manifestation of systemic atherosclerosis and is associated with significant morbidity and mortality. Diabetes is known to increase the risk of PAD two- to four-fold. The prevalence of PAD in Korean diabetic patients has not been established. In this study, we investigated the prevalence of PAD in Korean patients with type 2 diabetes attending a large university hospital and analyzed the factors associated with PAD. Methods: A total of 2,002 patients with type 2 diabetes who underwent ankle-brachial index (ABI) measurement in an outpatient clinic were enrolled. PAD was defined as an ABI ≤0.9. Clinical characteristics of 64 patients with PAD were compared with those of 192 age- and sex-matched control patients without PAD. Results: Of the 2,002 type 2 diabetic patients, 64 (3.2%) were diagnosed as having PAD. PAD was associated with higher prevalences of retinopathy, nephropathy, neuropathy, cerebrovascular and coronary artery disease. Patients with PAD had higher systolic blood pressure and serum triglyceride level and reported higher pack-years of smoking. Multivariate analysis showed that the presence of micro- and macrovascular complications and high systolic blood pressure are factors independently associated with PAD. Conclusion: The prevalence of PAD in diabetic patients was 3.2%, suggesting that the prevalence in Korean diabetic patients is lower than that of patients in Western countries.

Molecular Mechanisms of Appetite Regulation

유지희,김민선 대한당뇨병학회 2012 Diabetes and Metabolism Journal Vol.36 No.6

The prevalence of obesity has been rapidly increasing worldwide over the last several decades and has become a major health problem in developed countries. The brain, especially the hypothalamus, plays a key role in the control of food intake by sensing metabolic signals from peripheral organs and modulating feeding behaviors. To accomplish these important roles, the hypothalamus communicates with other brain areas such as the brainstem and reward-related limbic pathways. The adipocyte-derived hormone leptin and pancreatic β-cell-derived insulin inform adiposity to the hypothalamus. Gut hormones such as cholecystokinin,peptide YY, pancreatic polypeptide, glucagon-like peptide 1, and oxyntomodulin transfer satiety signals to the brain and ghrelin relays hunger signals. The endocannabinoid system and nutrients are also involved in the physiological regulation of food intake. In this article, we briefly review physiological mechanisms of appetite regulation.

청소년의 폭력적 미디어 노출이 사이버불링 가해행동에 미치는 영향: 정서조절과 비행행동의 이중매개효과를 중심으로

유지희 한국학교사회복지학회 2023 학교사회복지 Vol.- No.63

본 연구는 청소년의 폭력적 미디어 노출이 이들의 사이버불링 가해행동에 미치는 영향에서정서조절과 비행행동의 이중매개효과를 검증한 것이다. 이를 위해 서울․경기지역의 중학교학생을 대상으로 설문조사를 실시하였다. 최종적으로 402명의 청소년들로부터 수집된 자료를PROCESS Macro for SPSS의 모델6을 활용하여 분석하였다. 본 연구의 주요 분석결과는 다음과 같다. 첫째, 청소년의 폭력적 미디어 노출이 사이버불링 가해행동에 미치는 직접적인 영향력과 첫 번째 매개변수인 정서조절의 효과는 통계적으로 유의미하지 않았으나, 두 번째 매개변수인 비행행동은 두 변수간 매개역할을 하고 있는 것으로 나타났다. 둘째, 청소년의 폭력적 미디어 노출이 사이버불링 가해행동에 이르는 경로에서 정서조절과 비행행동에 의한 이중매개효과가 확인되었다. 이상의 연구결과를 토대로 청소년들의 사이버불링을 감소시킬 수 있는 임상적․정책적 방안에 대해 논의하였다. The purpose of this study was to examine the dual mediating effect of emotional regulation and delinquent behavior in the influence of the exposure to violent media on the cyberbullying perpetration among youth. For this purpose, survey was conducted to 402 adolescents in middle schools based in Seoul and Gyeonggi-do. Data were analyzed using SPSS Macro process. Finding were as follows:, First, the direct effect of exposure to violent media on cyberbullying perpetration was not significant. Second, emotional regulation did not mediate the influence of the exposure to violent media on the cyberbullying perpetration. Third, delinquent behavior was found to mediate the relationship between the exposure to violent media and cyberbullying perpetration among youth. Forth, emotional regulation and delinquent behavior dual-mediated the influence of the exposure to violent media on the cyberbullying perpetration. Based on results, implications were discussed to intervene in preventing cyberbullying perpetration among youth.

Matrix Pencil 방법에 의한 비행기 모형의 ISAR 영상화

유지희,권경일,이용희 한국전자파학회 2001 한국전자파학회논문지 Vol.12 No.2

이 논문에서는 MP(Matrix Pencil) 방법을 이용한 ISAR(Inverse Synthetic Aperture Radar) 영상에 대한 실험적 연구결과를 기술하였다. 측정은 CR(Compact Range) RCS 측정시설을 이용하였으며 두 가지 종류의 표적이 사용되었다. 첫 번째 표적은 MP의 성능을 확인하기 위하여 길이가 짧고 반경이 작은 원통형 표적이고 두 번째 표적은 실제 비행기 형상과 같이 복잡한 구조를 가진 무인항공기 모형이다. ISAR 영상을 얻기 위하여 MP와 FFT(Fast Fouier Transform)를 이용하였으며 실험결과를 비교해 보면 MP 방법을 사용하는 것이 기존의 FFT를 사용하는 것보다 더 좋은 영상을 얻을 수 있다는 것을 입증하였다. This paper presents a experimental study of Inverse Synthetic Aperture Radar(ISAR) imaging using Matrix Pencil(MP) method. A series of measurement for two types of target model was done in a Compact Range(CR)facility. The first target is a set of distributed slim cylinders to get a ISAR image of point-like scatterers. The second is UAV model representing a complex real target. The results show that ISAR images by MP method are better than by conventional FFT method under the realistic measurement conditions.

악성 담도 폐쇄에서 큰 내경의 피막형 금속배액관의 안전성과 효용성에 대한 연구

유지희,도민영,김연수,유성환,장성일,조재희,이동기 대한내과학회 2020 대한내과학회 추계학술대회 Vol.2020 No.1

Incidence and Risk Factors for Dementia in Type 2 Diabetes Mellitus: A Nationwide Population-Based Study in Korea

유지희,한경도,박상현,조한나,이다영,Jin Wook Kim,Ji A Seo,Sin-Gon Kim,Sei Hyun Baik,Yong Gyu Park,Kyung Mook Choi,Seon Mee Kim,Nan Hee Kim 대한당뇨병학회 2020 Diabetes and Metabolism Journal Vol.44 No.1

Background: Diabetes mellitus is associated with an increased risk of dementia. We aimed to comprehensively analyze the incidence and risk factors for dementia and young-onset dementia (YOD) in diabetic patients in Korea using the National Health Insurance Service data. Methods: Between January 1, 2009 and December 31, 2012, a total of 1,917,702 participants with diabetes were included and followed until the date of dementia diagnosis or until December 31, 2015. We evaluated the incidence and risk factors for all dementia, Alzheimer’s disease (AD), and vascular dementia (VaD) by Cox proportional hazards analyses. We also compared the impact of risk factors on the occurrence of YOD and late-onset dementia (LOD). Results: During an average of 5.1 years of follow-up, the incidence of all types of dementia, AD, or VaD was 9.5, 6.8, and 1.3/1,000 person-years, respectively, in participants with diabetes. YOD comprised 4.8% of all dementia occurrence, and the ratio of AD/ VaD was 2.1 for YOD compared with 5.5 for LOD. Current smokers and subjects with lower income, plasma glucose levels, body mass index (BMI), and subjects with hypertension, dyslipidemia, vascular complications, depression, and insulin treatment developed dementia more frequently. Vascular risk factors such as smoking, hypertension, and previous cardiovascular diseases were more strongly associated with the development of VaD than AD. Low BMI and a history of stroke or depression had a stronger influence on the development of YOD than LOD. Conclusion: The optimal management of modifiable risk factors may be important for preventing dementia in subjects with diabetes mellitus.

The Prevalence of Peripheral Arterial Disease in Korean Patients with Type 2 Diabetes Mellitus Attending a University Hospital (Diabetes Metab J 2011;35:543-50)

유지희,이기업 대한당뇨병학회 2012 Diabetes and Metabolism Journal Vol.36 No.1

일 대학병원 정신과 외래 환자의 약물 순응도에 영향을 미치는 요인

유지희,우영섭,한창태,최지욱,고효진 대한정신약물학회 2010 대한정신약물학회지 Vol.21 No.1

Objective Drug compliance is closely related to progress and prognosis of psychiatric disease. We investigated drug compliance in psychiatric outpatients and factors that influence their compliance. Methods Patients who visited a university hospital were asked about drug information and drug compliance using questionnaires. Medical records of the patients were reviewed. Demographic variables, clinical characteristics and drug compliance related variables were compared between non-compliance group and compliance group. Logistic regression analysis was performed to clarify predictors of poor compliance. Results One hundred eighty one patients participate in this study. 150 patients (82.9%) were compliance group, 31 patients (17.1%) were included in non-compliance group. Patient-related, illness-related and treatment-related factors, DAI total score and knowledge of side effect did not show any difference in both groups. However, illness severity was relatively higher in non-compliance group (p = 0.070) and patient’s satisfaction about explanation of side effect was lower in noncompliance group (p = 0.061). Moreover, patients who negatively answered for question about negative recognition to psychiatric medication in DAI questionnaire were more common in non-compliance group (p = 0.075). In logistic regression,answering negatively to question about negative recognition to psychiatric medication in DAI questionnaire was related to non-compliance, but did not reached statistical significance (p = 0.086). Conclusion This study suggests that improving negative recognition about psychiatric medication through drug education and good doctor patient relationship could enhance drug compliance. 정신과 환자에서 약물치료에 대한 순응도는 질환의 경과및 예후와 밀접하게 관련된다. 이에 본 연구에서는 대학병원 정신과 외래 환자를 대상으로 약물 순응도를 조사하고이에 영향을 미치는 요소를 파악하고자 계획하였다. 연구방법은 자가 보고식 응답에 의하여 약물 순응군과 약물 비순응군으로 구분한 후 각각의 그룹에 대해 연령, 성별 등의사회인구학적 변인과 정신과적 진단명, 신체적 질환 여부,임상변인을 비교 하였다. 결과로는 약물 및 부작용에 대한설명과 이에 대한 만족도, 정신과 약물에 대한 주관적, 부정적 태도 만이 약물 순응도에 영향을 주는 것으로 나타났다. 따라서 환자 개인이 가지고 있던 정신과적 약물치료에대한 부정적 인식을 개선하는 것이 약물 순응도를 높이는데 효과적일 것으로 예상할 수 있다.