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처음 진단된 제2형 당뇨병 환자의 1일 보수 증가에 의한 당대사 및 운동 능력의 변화
안근희 ( Keun Hee An ),안희정 ( Hee Jung Ahn ),임강일 ( Kang Il Lim ),한경아 ( Kyung Ah Han ),민경완 ( Kyung Wan Min ) 대한내과학회 2006 대한내과학회지 Vol.71 No.4
목적: 규칙적인 운동은 제2형 당뇨병 환자의 대사상태를 개선시키고 운동 능력을 향상 시킨다. 그렇지만 한국인 제2형 당뇨병 환자의 47.5%는 운동을 거의 하지 않고 지내고 있다. 이에 운동을 하지 않고 지내던 제2형 당뇨병 환자를 대상으로 보수 측정계를 이용한 걷기 훈련이 당대사 및 운동능력에 미치는 영향을 알아보고자 하였다. 방법: 대상자는 본원에서 처음으로 제 2형 당뇨병을 진단 받았으며 규칙적인 운동을 하고 있지 않은 환자 29명을 대상으로 하였다. 보수측정계를 착용하여 12주 동안 1일 보수를 측정하도록 하였으며 1일 1만보 이상을 걷도록 훈련하였다. 훈련 전과 12주 훈련 후에 허리둘레, 체질량지수, 당대사, 인슐린저항성, 지질대사 및 운동능력을 측정하여 비교하였다. 결과: 훈련 12주 후 1일 보수는 약 1만보(p<0.001) 이상 유의하게 증가하였다. 대상자의 체질량지수(p<0.001)와 허리둘레(p=0.011)는 유의하게 감소하였고, 공복 혈당과 식후 2시간 혈당(p<0.001), 당화혈색소(p=0.003) 모두 유의하게 감소하였다. 환자의 무산소성 역치에서의 운동부하(p<0.001)와 산소섭취량(p<0.001), 최대운동시의 운동부하(p<0.001)와 산소섭취량(p<0.001)이 12주 훈련 후 증가 하였으며, 훈련 후 1일 보수와 당화혈색소의 변화는 음의 상관관계(r=-0.711, p<0.001)를 보였다. 또한 12주간의 훈련 후 1일 보수와 최대산소 섭취량의 변화는 양의 상관관계를 보였다(r=0.46, p<0.05). 결론: 처음 당뇨병을 진단받은 한국인 제2형 당뇨병환자에 있어 약 1만보의 1일 보수의 증가는 당대사 및 유산소 운동능력을 향상시켰다. 따라서 쉽게 사용할 수 있는 보수 측정계는 운동을 하지 않고 지내는 제2형 당뇨병 환자의 활동량을 늘리는 효과적 방법이다. Background: Regular exercise improves glycemic control and exercise capacity. However, 47.5% of Korean patients with type 2 diabetes do not take part in exercise at least once a week. A recommendation to accumulate 10,000 steps throughout the day has many advantages. The purpose of this study was to investigate the effects of increasing the number of walking steps per day on glycemic control and exercise capacity using a pedometer in newly diagnosed type 2 diabetics who did not take part in exercise at least once a week. Methods: We included twenty nine Korean type 2 diabetic patients aged 46-62 years who presented with newly diagnosed type 2 diabetes and did not take part in exercise at least once a week. They were encouraged to walk more than 10,000 step/day and the daily steps were recorded using pedometers. A gradual loading exercise test was administered, with an electric stationary upright cycle ergometer, to estimate the rate of oxygen consumption (VO2), exercise time, load and metabolic equivalent (MET) before and after 12 weeks of walk training. Before and after the intervention, metabolic and lipid profiles and aerobic exercise levels were evaluated for all subjects. Subject descriptive comparisons were made with paired t-tests. The Pearson`s correlation coefficients were calculated as well to analyze the linear relationship among variables. Results: The results showed that the number of steps per day were increased to about 10,000 steps per day (p<0.001). Body mass index (p<0.001), abdominal circumference (p=0.011), aerobic exercise capacity level and glycemic control were significantly improved (p<0.001). However, lipid profiles were not affected during the exercise intervention. There was a positive correlation between increases in steps per day and changes of aerobic capacity such as peak VO2 (r=0.46, p<0.05). Also, increases in steps per day were negatively correlated with changes in HbA1c (r=-0.711, p<0.001). Conclusions: This study suggests that both glycemic control and aerobic capacity are improved with increasing the number of steps to over 10,000 steps per day in newly diagnosed Korean type 2 diabetics. Our result suggest that a pedometer may be used as a simple and effective method of encouraging physical activity to type 2 diabetics who did not take part in exercise at least once a week.(Korean J Med 71:388-395, 2006)
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제2형 당뇨병 환자의 운동교육에 의한 소비칼로리 차이가 혈당 및 지질대사에 미치는 영향
안근희(An Keun-Hee) 한국체육과학회 2010 한국체육과학회지 Vol.19 No.2
The purpose of this study was to determine the effects of differences in energy expenditure on glucose control and lipid profile in type 2 diabetics. For this purpose, the subjects participating in the study were type 2 diabetic patients who were divided into two groups: exercise group-one educated about energy expenditure with lifecorder(Suzuken Co., Nagoya, Japan) and control group-not specifically instructed about energy expenditure. Glucose control, lipid profile and physical activity indices were treasured and analyzed. Each program was implemented for 1 session per week, over 12 weeks. For data analysis, the mean and standard error were estimated; paired t-test was taken for measuring pre and post values in each group; and group differences were made for treasures of one way ANOVA. Thus the following results were obtained. 1. Body weight, basal metabolic rate and body mass index significantly dropped in both groups. There were significant differences in body weight after the training between exercise and control group. 2. Fasting blood sugar(FBS) and post prandial 2 hours glucose(PP2) were not significantly decreased in each group. But there were significant differences in FBS, PP2 after the period between the two groups. High density lipoprotein cholesterol(HDL-C) was increased after the period in each group. Total cholesterol level fell in the exercise group. 3. There were significant differences in total energy expenditure calorie, step and activity time per day after the period between the two. Total activity time per day was on the significant rise in both groups. Physical activity calroie per weight, physical activity calorie and total step were significantly increased in exercise group.
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7일간 신체활동 회상법에 의한 제2형 당뇨병 환자의 신체활동량 평가
안근희(An Keun-Hee) 한국체육과학회 2008 한국체육과학회지 Vol.17 No.3
Despite the scientific community's recognition of the importance of exercise, little is known about the epidemiology of exercise among persons with diabetes in the Korea. Our goals were to compare whether people with diabetes were more sedentary than people without diabetes, and to compare whether the choice of activities differs among people with and without disease. We analyzed data from 139(Age 58.78±11.75, Men 48, Women 91, Body mass index 24.86±7.84㎏/m2)with self-reported method(physical activity seven day recall) of type 2 diabetes in the 5 hospital. Energy expenditure estimates from the physical activity recall conformed to matched gender. Self-reports of light activity (1~2.9METs), moderate activity(3~5METs), hard(5.1~6.9METs), very hard(7METs≤) and energy expenditure were described. Men with diabetes were higher body mass index than that of women(28.86±6.65 vs 24.86±7.84㎏/m2)(p=.01). Fifty one percents of people with diabetes were not exercising regularly. Walking time(30min<) was similar for both group(70.83% vs 74.73%). Energy expenditure of type 2 diabetics by office work(p=.054) and house work (p=.001)was significant difference by gender. Energy expenditure by exercise was not significant difference by both groups. Hard physical activity and total energy expenditure per day were significant difference by gender(p=.001). Light physical activity(<700Kcal) per week of type 2 diabetics was 60.43%. Individuals with diabetes should be encouraged to exercise regularly and to increasing exercise work.
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안근희(An Keun-Hee) 한국체육과학회 2008 한국체육과학회지 Vol.17 No.1
The purpose of this study was to explore the effects of each exercise education method in type 2 diabetic patients. Participants(N:51) had been randomly assigned to group 1(individual exercise education) and group 2(group exercise education) in type 2 diabetic patients. Group 1 was carried out at 20min per time, 1 time per 2 weeks, 6times per 3months and group 2 was carried out 1hour per time, 1 time per 6weeks, 2time per 3months. The analysis of data revealed the following results. 1) Muscle mass and percent fat were significantly improved after education period in all group. Waist to hip ratio was significantly decreased after education period in only group 1. However, there were no significant deferences in it among groups. 2) Fasting insulin and postprandial 2hours glucose were significantly decreased after education period in group 1. Fasting glucose and postprandial 2hours glucose were significantly decreased after 3 months in group 2. However, there were no significant deferences in it among groups. 3) METs at anaerobic threshold and maximal exercise was significantly decreased after 3months in group 2. There were significant deference in METs at anaerobic threshold and maximal exercise between group 1 and 2. These results suggests that individual exercise education might have nearly comparable effects on METs at anaerobic threshold and maximal exercise. We need to develop comprehensive program about exercise education for strict glycemic control and lipid profile in diabetic patients.
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