2008년, 이것만은 지키자-즐거운 마음이 혈당도 관리해준다!

송복례,Song, Bok-Rye 사단법인 한국당뇨협회 2008 당뇨 Vol.218 No.-

연말연시가 되면 늘 그랬듯이 새해 새 마음으로 살자고 다짐한 게 엊그제 같은데 어느새 또 다른 새해가 코앞에 와있다는걸 느끼곤 '참세월 빠르구나' 하는생각이 들곤 합니다. 새해를 맞이할 때는 계획도 풍성히 새로운 마음도 넉넉히 준비하지만 막상 연말이 되면 온전하게 맺어 놓은 것이 별로 없음에 공허한 웃음만 만들어 냅니다. 하지만 인생은 이렇듯이 늘 새로운 희망과 후회라는 그림자가 항상 함께 하는 것을 알기에 조금 더 나은 미래의 손짓에 또 즐거운 한해를 맞이하게 되었습니다. 당뇨병 관리를 잘 하는 것은 누구나의 소망이지만 잘 관리한다는 것은 매우 어렵습니다. 모든 일에는 굴곡이 있듯이 혈당도 변화가 있을 수 있기 때문에 당뇨병을 관리하는 것은 생활비를 쓰는 것과 같다고들 합니다. 매달 똑같은 생활비를 쓸 수 없는 것처럼 항상 똑같은 혈당을 유지하기는 어렵습니다. 예를 들어 100만원을 매달 생활비로 사용한다면 이번 달은 90만원을 쓸 수 있고 다음 달은 110만원을 사용할 수도 있는 것처럼 이렇게 조금씩은 덜어내고 보태서 사용하는 겁니다. 모든 일이 완벽할 수는 없기에 당뇨병에 대한 생각과 느낌 즉 마음가짐은 매우 중요합니다. 그럼 이런 당뇨병을 어떻게 맞이해야 할까요?

당뇨병 환자의 여행 중의 발 관리 요령

송복례 사단법인 한국당뇨협회 2002 당뇨 Vol.152 No.-

당뇨병 합병증 검사의 종류와 주의사항

송복례 ( Bok Rye Song ) 대한당뇨병학회 2009 임상당뇨병 Vol.10 No.3

고인슐린혈증과 심혈관질환 위험요인과의 관련성

이강숙,송복례 한국역학회 1998 Epidemiology and Health Vol.20 No.1

당뇨병 표준진료지침 적용 효과에 관한 연구

신미옥,서신원,송복례,김경희,윤건호,유양숙,김희승 한국의료QA학회 2000 한국의료질향상학회지 Vol.7 No.1

Background : The aim of this study was to examine the effectiveness of the critical pathway to diabetic patients who were admitted in the hospital. Methods : For establishment of critical pathway for diabetic patients, we organized the multidisciplinary care team. During 5 months, 31 diabetic inpatients were applied the critical pathway and the results were compared with 11 diabetic inpatients who were treated with conventional way. We assessed the patients satisfaction, knowledge on the disease, compliance of medical regimen, length of stay(LOS) and hospital cost. We used the computer program SAS for statistical analysis. Data were summarized with mean, and analyzed using t-test repeated measures ANOVA and Wilcoxon rank sum test. Results : Length of stay(LOS) was remarkably shortened in critical pathway group compared with the conventional treatment group(7.6±1.23 vs 12.0±4.73, p<0.000). Although LOS was significantly shortened in critical pathway group, patients satisfaction was much higher than conventional treatment group. There were no significant difference of knowledge on the disease, compliance of medical regimen and blood glucose level between two groups at discharge. Hospital cost of each patients also significantly decreased in critical pathway group(890,000 won vs 1,280,000 won, p<0.05). Conclusion : These results showed that establishment of critical pathway for diabetic inpatients with team approach is the one of the way to improve the quality of diabetic patients management and to enhance the efficiency of hospital management.

인터넷을 이용한 새로운 혈당 관리 체계의 구축

김희수,조재형,권혁상,이진희,송복례,오정아,윤건호,손호영 대한당뇨병학회 2003 Diabetes and Metabolism Journal Vol.27 No.3

The effect of Type 2 diabetes management using a smartphone-based blood glucose management training program

이정화,정진희,심강희,최희선,이정림,강양교,송복례 대한산업경영학회 2022 산업융합연구 Vol.20 No.9

Background: Diabetes education is an important factor in blood glucose control. Reinforced education is necessary for effective diabetes education. However, it is difficult to provide reinforced diabetes education within Korea's medical environment. Therefore, we want to analyze the effect of continuous diabetes education using mobile health care that can effectively provide repeated education without having to face the patient. Methods: This study is a multicenter, randomized, controlled, pre-post design study conducted to analyze the effect of a continuous diabetes education method. A total of 109 people were registered at five hospitals in south Korea, and they were randomly assigned to the app group (34 people) who received real-time coaching and repetitive training, the logbook group (37 people) who received face-to-face training after writing a blood glucose logbook, and the general group (38 people) who received a one-time diabetes education. The study was conducted for a total of 24 weeks. Twenty-one patients withdrew their consent and failed to perform an HbA1c. A final 88 patients were analyzed. The difference in HbA1c, Self-management behavior, and Quality of life before and after education was analyzed. Results: The study involved 51 (58%) male subjects, mean age was 55.8 years and mean duration of diabetes was 7.6 years. After 24 weeks of intervention, there was no significant difference in self-care behavior and quality of life between the three groups, but the HbA1c of the app group significantly decreased after education compared to the logbook group and the general group (F=4.62, p=.013). Conclusion: It can be seen through the app group that receiving real-time education is more effective in improving blood glucose management and continuous diabetes education is important.

Current Status of Management in Type 2 Diabetes Mellitus at General Hospitals in South Korea

정진희,이정화,노진원,박정은,김희숙,유주화,송복례,이정림,홍명희,장향미,나영,이현주,이정미,강양교,김선영,심강희 대한당뇨병학회 2015 Diabetes and Metabolism Journal Vol.39 No.4

Background: In Korea, the prevalence, complications, and mortality rate of diabetes are rapidly increasing. However, investigations on the actual condition of diabetes management are very limited due to lack of nation-wide research or multicenter study. Hence, we have minutely inquired the current status of diabetes management and achievement of glucose target goal in general hospital offering education program. That way, we are able to furnish data for policy making of diabetes education and draw up guideline which may allow us to reduce the morbidity and mortality of diabetes. Methods: The subjects consisted of 2,610 patients with type 2 diabetes who visited the 13 general hospital in Seoul or Gyeonggi region from March 19 to May 29, 2013. General characteristics, associated diseases, complications, and management status were investigated. Results: The mean age was 61.0±11.6 years, body mass index was 25.0±3.3 kg/m2, and family history of diabetes was 50.5%. The mean duration of diabetes was 10.7±7.9 years and 53% received education about diabetes. The prevalence of hypertension and dyslipidemia were 59.2% and 65.5%, respectively, and 18.3% of the subjects were accompanied by liver disease. Diabetic retinopathy appeared in 31.6%, nephropathy in 28.1%, and neuropathy in 19.9% of the subjects. The mean glycosylated hemoglobin (HbA1c) level was 7.3%±1.3% and the achieving rate based on Korean Diabetes Association guideline (HbA1c <6.5%) was 24.8%, blood pressure (130/80 mm Hg or less) was 49.4%, and low density lipoprotein cholesterol (<100 mg/dL) was 63.6%. The reaching rate to the target level in four parameters (blood glucose, blood pressure, lipids, and body weight) was 7.8%. Conclusion: The blood glucose control rate was lower than other parameters, and the implementation rate of diabetes education was only 53%. Thus more appropriate glucose control and systematic diabetes education are imperative.

제2형 당뇨병 환자에게 적용한 표준진료지침이 혈당, 당화혈색소, 당뇨지식 및 재원일수에 미치는 효과

김희승,윤건호,유양숙,오정아,송민선,신미옥,김경희,송복례 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.1

연구배경 : 당뇨병 환자의 평균 재원기간을 단축시키고, 제한된 입원기간 내에서 질적인 면과 비용효과성을 고려한 총체적인 건강관리체계의 필요성이 요구됨으로써 생겨난 것이 당뇨병 표준진료지침(Critical Pathway: CP)이다. 현재 개발된 당뇨병 CP를 통한 진료가 환자의 당뇨병에 관한 지식을 개선시키고 이에 따라 장기적으로 당뇨병 환자의 혈당조절이 개선되었다는 과학적인 검증은 당뇨병 CP를 여러 병원에 정착시키기이전에 반드시 선행되어야 할 과제이다. 이에 본 연구는 2000년 3월부터 1년간 강남성모병원에 입원하는 당뇨병 환자를 대상으로 현재 개발된 1주일 CP를 적용한 실험군의 혈당, 당뇨병 관련 지식 및 재원일수가 대조군에 비하여 차이가 있는지를 조사하였다. 방법 : 1주일 CP를 적용한 실험군은 내과병동에 입원한 당뇨병 환자 89명이었고, 대조군은 기타병동에 입원한 당뇨병 환자 22명이었으며 CP를 적용하지 않았다. CP를 적용하기 전인 입원시에 실험군과 대조군의 공복혈당, 식후 2시간혈당, 당화혈색소 및 당뇨관련 지식을 측정하였고, 퇴원 시에 실험군과 대조군에게 공복혈당과 당뇨관련 지식을 재측정하고 재원일수를 파악하였다. 그리고 두 군에게 퇴원 3개월 후의 공복혈당, 식후 2시간 혈당 및 당화혈색소를 조사하였다. 결과 : 1) 실험군의 공복혈당은 입원 시 238.7: 1) 실험군의 공복혈당은 입원 시 238.7mg/dL에서 퇴원 시 139.4mg/dL로 감소하는 경향이었으나 퇴원 3개월 후에는 150.6mg/dL로 약간상승하는 경향을 보였다. 대조군은 입원 시 251.5mg/dL에서 퇴원 시 136.2mg/dL로 감소하는 경향이었으나, 퇴원 3개월 후에는 219.3mg/dL로 현저히 증가하는 경향이었다. 2) 실험군의 입원 시 식후 2시간 혈당은 312.5mg/dL에서 퇴원 3개월 후 248.5mg/dL로 감소하는 경향이었다. 대조군도 입원 시 식후 2시간 혈당이 300.1mg/dL에서 퇴원 3개월 후 262.5mg/dL로 감소하는 경향이었으나 실험군보다 감소의 폭이 적은 경향이었다. 3) 실험군과 대조군의 입원 시 당화혈색소는 각각 10.3%와 9.7%로 유의한 차이가 없었으나,퇴원 3개월 후 실험군은 7.5%로 대조군의 9.1% 보다 유의하게 감소하였다. 4) 실험군의 입원 시 당뇨지식 점수는 실험군이 12.1점 대조군은 12.0점으로 유의한 차이가 없었으나 퇴원 시는 실험군이 15.5점으로 대조군의 14.6점 보다 높은 경향이었다. 5) 재원일수는 실험군이 8.4일로 대조군의11.0일 보다 유의하게 적었다. 결론 : 따라서 당뇨병 환자를 위한 CP는 재원일수의 감소뿐만 아니라 환자의 자가관리에 대한 체계적인 교육과 개선의 기회를 가짐으로써 장기적인 혈당 조절의 향상을 도모할 수 있는 효과적인 방법이라고 생각한다. Background: The aim of this study was to examine the effects of the critical pathway for the admitted patients with type 2 dia betes me llitus on glycemic control, the knowledge on the disease, and the length of hospital stay. Methods: 89 diabetic in-patients were applied with the 1 week critical pathwa which was consisted of intensive education program for self-management of diabetes me llitus such as glucose monitoring, excercise prescription, diet control, self-a djustment of the drugs and so on. The results were compared with 22 diabetic inpatients who were treated with conventional way. We assessed the effects of critical pathway on the degree of glycemic control, the knowledge on the disease, and the length of hospital stay. Results: Although fasting and postprandial 2 hours blood g lucose levels did not showed sta tistically significantd ifference between critical pathway group and conventional group on discharge , HbA1c was significantly decreased in critical pathwa group compared with the conventional group (7.5±1.8% vs 9.1±2.6%) on 3 months after discharge . Knowledge on the disease tended to increase in critical pathway group compared with the conventional group on discharge. The Length of hospital stay was significantly decreased in critical pathway group compared with the conventional group (8.4±2.8day vs 11.0±3.9da ) Conclusion: These results showed that critical pathway for the patients with diabetes mellitus might be a usefulway for improving the long term glycemic control through motivation, enhancing the knowledge on the disase as well as reducing the length of hospital stay.

입원 당뇨병 환자를 위한 표준진료지침 개발 및 적용

조재형,김헌성,박예리,김현주,강미자,김규섭,위지선,임성훈,이지선,송복례,이현정,문계숙,김미선,박종택,조영이 한국의료QA학회 2008 가을학술대회 Vol.2008 No.3