우리나라 임상간호사의 당뇨병 지식 및 지식 확산도 조사연구

홍명희,유주화,김순애,이정림,노나리,박정은,구미옥 병원간호사회 2009 임상간호연구 Vol.15 No.3

Purpose: In order to increase the quality of nursing care for patients with diabetes mellitus, it is important for clinical nurses to accept changes in diabetes knowledge and correct their approach immediately. This approach will also contribute to effective nursing practice. Methods: The study was designed to investigate the level of knowledge and diffusion of knowledge for nursing care of patients with diabetes mellitus among clinical nurses. It was conducted with nurses from 29 general hospitals in Korea from November 3 to December 5, 2008. The questionnaire consisted of 129 items and it was sent to the participants by mail. Of the 1,060 questionnaires returned, only 930 were valid for use in the statistical analysis. Results: 1) The average score for clinical nurses' knowledge of diabetes mellitus was 0.67 out of 1.0. 2) The level of persuasion of knowledge for nursing care of patients with diabetes mellitus averaged 0.64 out of 1.0 3) The level of practical application of knowledge for nursing care of patients with diabetes mellitus averaged 1.05 out of 2.0, indicating that they applied their knowledge sometimes . 4) The level of diffusion of knowledge for nursing care of patients with diabetes mellitus was 2.37 out of 4.0 and level was estimated as the stage of persuasion . 5) There were significant differences in nursing knowledge of diabetes mellitus, according to experience in practical education for diabetes mellitus. Conclusion: The results indicate that nurses with a lower level of knowledge of diabetes mellitus have a lower level of persuasion of knowledge for nursing care of patients with diabetes mellitus and lower practical application. To improve the level of nurses' knowledge of diabetes mellitus, practical training programs are needed for areas in which knowledge level is low, such as diagnosis and management of diabetes mellitus , oral diabetes medication , and glucose control in special conditions .

당뇨병 환자의 건강정보이해능력과 복약 순응도 및 자가 관리와의 관계

윤수지 ( Yoon Suji ) 이화간호과학연구소 2017 Health & Nursing Vol.29 No.1

Purpose: This study was to identify the relationships of health literacy, medication adherence and self-care performance for patients with diabetes mellitus. Method: 110 Patients with diabetes mellitus were recruited from one hospital in Seoul, using Korean Health Literacy Assessment Tool for health literacy, Korean version of Morisky Medication Adherence Scale for medication adherence, and Korean version of Summary of Diabetes Self-Care Activities Questionnaire for self-care performance. The collected data were analyzed using SPSS version 22.0 the mean, standard deviation, t-test, ANOVA, Scheffe test, and multiple linear regression. Results: Other medical history of chronic disease(B=2.085, p<.05), time since diabetes mellitus diagnosis(B=-.631, p<.001), complications associated with diabetes mellitus(B=-3.119, p<.05), and health literacy(B=1.132, p<.01), each found to affect self-care performance and time sincce diabetes mellitus has the largest effect (B=-.631, p<.001). Model`s R<sup>2</sup> is 0.592. Conclusion: Self care performance of patients with diabetes mellitus was affected by other medical history of chronic disease, diabetes mellitus diagnosis duration, complications associated with diabetes mellitus and health literacy. Among these factors, diabetes mellitus diagnosis duration had the largest effect. Therefore, to improve diabetes mellitus patients`s self-care performance, an integrative approach should be pursued considering patient`s diabetes mellitus diagnosis duration, complications associated with diabetes mellitus and health literacy.

Diabetes Fact Sheet in Korea 2021

배재현,한경도,고승현,양예슬,최종한,최경묵,권혁상,원규장 대한당뇨병학회 2022 Diabetes and Metabolism Journal Vol.46 No.3

Background: This study aimed to investigate the prevalence and management of diabetes mellitus, risk-factor control, and comorbidities among Korean adults.Methods: We conducted a cross-sectional analysis of data from the Korea National Health and Nutrition Examination Survey to assess the prevalence, treatment, risk factors, comorbidities, and self-management behaviors of diabetes mellitus from 2019 to 2020. We also analyzed data from the Korean National Health Insurance Service to evaluate the use of antidiabetic medications in people with diabetes mellitus from 2002 through 2018.Results: Among Korean adults aged 30 years or older, the estimated prevalence of diabetes mellitus was 16.7% in 2020. From 2019 through 2020, 65.8% of adults with diabetes mellitus were aware of the disease and treated with antidiabetic medications. The percentage of adults with diabetes mellitus who achieved glycosylated hemoglobin (HbA1c) <6.5% was 24.5% despite the increased use of new antidiabetic medications. We found that adults with diabetes mellitus who achieved all three goals of HbA1c <6.5%, blood pressure (BP) <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL were 9.7%. The percentage of self-management behaviors was lower in men than women. Excess energy intake was observed in 16.7% of adults with diabetes mellitus.Conclusion: The prevalence of diabetes mellitus among Korean adults remained high. Only 9.7% of adults with diabetes mellitus achieved all glycemic, BP, and lipid controls from 2019 to 2020. Continuous evaluation of national diabetes statistics and a national effort to increase awareness of diabetes mellitus and improve comprehensive diabetes care are needed.

Osteoporosis and Fracture among Patients with Type 1 and Type 2 Diabetes

홍서유,박은주 대한골다공증학회 2010 Osteoporosis and Sarcopenia Vol.8 No.1

Diabetes mellitus is a major risk factor for osteoporotic fractures. The occurrence of Osteoporosis among patients who have diabetes mellitus further increases both economically and physically their burden of disease. Nevertheless, osteoporotic screening or prophylactic treatment for all patients with type 1 and type 2 diabetes mellitus is not being recommended at present. The reason is that neither the relationship between diabetes and osteoporosis and nor differences between type 1 and type 2 diabetes mellitus are clear. At present, while low bone mineral density (BMD) is consistently observed in type 1 diabetes mellitus, the relationship is less clear for type 2 diabetes mellitus, with some studies reporting modestly increased or an unchanged BMD. Both type 1 and type 2 diabetes mellitus have been associated with a higher risk of fractures. The presence of micro- and macro-vascular diabetic complications as a result of long standing poor glycemic control, rather than long duration predict low BMD in patients with type 1 diabetes mellitus. In type 2 diabetes mellitus patients, obesity protects bone loss and increases BMD. Nevertheless, hypoglycemic episodes under insulin therapy with commonly established risk factors of falls such as advanced age, impaired balance, a history of coronary heart disease or arthritis and peripheral neuropathy may have contributed to the increased risk for falls and result in fractures. We suggest that osteoporosis screening and prophylactic treatment for all patients with type 1 and 2 diabetes mellitus needs to be recommended along with considerations of each individual’s risk profile for osteoporotic fractures.

당뇨캠프에 참석한 당뇨병환아의 자기간호수행에 관한 조사연구

한경자,최명애,강창희,구미옥 서울대학교 간호대학 간호과학연구소 1995 간호학 논문집 Vol.9 No.1

The purpose of this study was to identify the degrees of performing self-care activities, knowledge about juvenile diabetes mellitus and symptom experience, and to investigate the performance of self-care activities by general characteristics, knowledge, symptom experience. The ultimate aim was to provide a basic data in developing nursing intervention for the children with diabetes mellitus. The subjects of this study were 42 juvenile diabetic children aged between 8 and 18 who had participated in a diabetes mellitus camp for diabetic children from July 7 to 10,1990. The subjects filled out questionnaires with knowledge about diabetes mellitus, symptom experience of diabetes mellitus, performance of self-care activities during the last 2 days of the camp. Four nursing students who had experienced with nursing care of diabetic children explained the content of the questionnaires ot the subjects. The results were as follows: 1. Mean score of performing self-care activities was 52.95, that of self-care about diet 15.68, that of self-care about blood glucose control 25.69, and that of self-care about general care 11.59. That is, 75.6% of the subjects performed self-care activities, 62.7% self-care about diet, 85.6% self-care about blood glucose control, and 77.3% self-care about general care. 2. Fifteen subjects (65.7%)scored 12 to 14, 10(23.8%) scored 10 to 11,and 7(16.7%) scored 7 to 9 in the total of 14 questions of the knowledge of diabetes mellitus. Mean score of it was 0.79 on a 0-1 point scale. 3. Of the subjects, 22 (52,4%) experienced 4 to 6 symptoms, 14 subjects 1 to 3 symptoms, and the rest 7 to 9 symptoms. Twenty-five subjects (59.5%) had no complication of diabetes mellitus, while 9(21.4%) experienced 1 complication. 4. Mean score of performing self-care about diet in diabetic children aged between 8 and 12 was significantly higher than that of those aged between 13 and 18 (P=0.0026). 5. Mean score of performing self-care about diet in primary school children was significantly greater than that of high school adolescents(P=0.003). 6. There was no significant difference in performing self-care activities, self-care activities about diet, blood glucose control, and general care by gender, religion, duration of illness, experience of hospitalization, number of participation of diabetes mellitus camp, and family history of diabetes mellitus. 7. No significant difference was observed in performing self-care activities and self-care activities about diet, blood glucose control and general care by the level of knowledge about diabetes mellitus. 8. There was no significant difference in performing self-care activities, self-care activities about diet, blood glucose control, and general care by the degree of symptom experience. These results suggest that the age is an important variable in self-care activities of diabetic children. Nursing intervention might be essential to reinforce the self-care activities for high school adolescents and to maintain the self-care activities for primary school children. And the content of existing diabetes mellitus camp program may be revised or added by the age in order to promote the practice of self-care activities of diabetic children.

Depressive Symptoms Are Negatively Associated with Glucose Testing and Eating Meals on Time among Individuals with Diabetes in Zambia

Given Hapunda,Amina Abubakar,Frans Pouwer,Fons van de Vijver 대한당뇨병학회 2017 Diabetes and Metabolism Journal Vol.41 No.6

Background: Depression is an established risk factor for cardiovascular diseases and mortality among individuals living with diabetes, and impaired self-care behaviors may play a mediating role. In Africa, this association is not very well known. In this study, we examined the associations between depressive symptoms and different aspects of diabetes self-care in Zambian individuals with diabetes mellitus. Methods: A total of 157 individuals with diabetes mellitus participated. The sample was drawn from four city hospitals in Zambia. Diabetes self-care was assessed using the diabetes self-care inventory, and depression was assessed using the major depression inventory. Results: Fifty-nine percent of the sample had type 1 diabetes mellitus. Variations in self-care activities and behaviors were reported as least adhered to by individuals with type 1 and type 2 diabetes mellitus, in adolescent and adult patients. Regression analysis indicated that there was no association between total diabetes self-care and the depression total score. However, depression was associated with poor glucose testing and not eating meals on time by patients with diabetes. Conclusion: Some variance on poor self-care was explained by demographic characteristics, specifically age, body mass index, and to some extent, socioeconomic status. Recognition and successful treatment of depression in patients with diabetes might help to optimize self-care behaviors, especially glucose testing and eating meals on time. However, this hypothesis needs further testing.

Blood Pressure Target in Type 2 Diabetes Mellitus

김현진,김광일 대한당뇨병학회 2022 Diabetes and Metabolism Journal Vol.46 No.5

The prevalence of diabetes mellitus continues to increase worldwide, and it is a well-established cardiovascular risk factor. Hypertension is also an important cardiovascular risk factor to be controlled and is common among patients with diabetes mellitus. Optimal blood pressure (BP) goals have been the subject of great debate in the management of hypertension among patients with diabetes mellitus. This review provides detailed results from randomized controlled trials and meta-analyses of clinical outcomes according to the target BP in patients with type 2 diabetes mellitus. In addition, the target BP in patients with diabetes mellitus recommended by different guidelines was summarized and presented. A target BP of <140/90 mm Hg is recommended for patients with hypertension and diabetes mellitus, and BP should be controlled to <130/80 mm Hg in patients with diabetes mellitus who have high-risk clinical features. We hope that this review will be helpful to clinicians and patients by promoting the understanding and appropriate application of BP control in the comprehensive management of patients with diabetes mellitus.

Prevention of type 2 diabetes mellitus in women with previous gestational diabetes mellitus

( Joon Ho Moon ),( Soo Heon Kwak ),( Hak C. Jang ) 대한내과학회 2017 The Korean Journal of Internal Medicine Vol.32 No.1

Gestational diabetes mellitus (GDM), defined as any degree of glucose intolerance with onset or first recognition during pregnancy, is characterized by underlying maternal defects in the β-cell response to insulin during pregnancy. Women with a previous history of GDM have a greater than 7-fold higher risk of developing postpartum diabetes compared with women without GDM. Various risk factors for postpartum diabetes have been identified, including maternal age, glucose levels in pregnancy, family history of diabetes, pre-pregnancy and postpartum body mass index, dietary patterns, physical activity, and breastfeeding. Genetic studies revealed that GDM shares common genetic variants with type 2 diabetes. A number of lifestyle interventional trials that aimed to ameliorate modifiable risk factors, including diet, exercise, and breastfeeding, succeeded in reducing the incidence of postpartum diabetes, weight retention, and other obesity-related morbidities. The present review summarizes the findings of previous studies on the incidence and risk factors of postpartum diabetes and discusses recent lifestyle interventional trials that attempted to prevent postpartum diabetes.

당뇨병 교육이 환자의 혈당 조절과 자가 관리에 미치는 영향

김지현 ( Ji Hyun Kim ),장상아 ( Sang Ah Chang ) 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.6

연구배경: 당뇨병은 지속적인 치료와 자기관리가 필요한 질환으로 이를 위한 효과적인 자가 관리의 강화와 당뇨병 교육이 중요하다. 현재 시행되고 있는 당뇨병 교육이 환자의 혈당 조절과 자가 관리 및 자아 효능감에 미치는 영향을 알아보고자 하였다. 방법: 2007년 1월부터 12월까지 당뇨병을 처음 진단받거나 당뇨병으로 치료하던 중 혈당 조절이 불량하여 당뇨병 교육을 받도록 한 592명의 환자 중에서 2008년 4월부터 7월까지 당뇨병 교육에 대한 설문 조사에 참여하고 임상 검사를 시행한 117명을 대상으로 하였다. 이들은 각각 교육받지 않은 군(비교육군, 23명)과 교육을 1회 이상 받은 군(교육군, 94명)으로 나누어 당뇨병의 자가 관리와 당뇨병에 대한 지식, 자기 효능감을 설문지를 이용하여 조사하였으며 임상적 검사 지표로는 당화혈색소, 혈당, 지질수치를 사용하였다. 결과: 당뇨병 교육군에서 비교육군에 비해 당화혈색소 감소치가 유의하게 높았다(P=0.039). 또한, 당뇨병 교육군에서 비교육군보다 당뇨병 지식 평가 점수가 유의하게 높았으나(P=0.005). 이러한 효과는 자가 관리와 당뇨병 치료에 대한 자아 효능감에는 반영되지 않았다. 결론: 당뇨병 교육군에서 혈당과 지질 수치가 향상되는 빈도와 당뇨병에 대한 지식수준이 높았다. 그러나 당뇨병 교육이 당뇨병의 자가 관리 및 효능감에 미치는 영향은 미미하게 나타났다. 그러므로, 실제 행동으로 실천할 수 있고 자아 효능감을 증진시킬 수 있는 효율적인 교육 방법의 개발이 필요하다. Background: Diabetes mellitus is a chronic disease requiring continuous treatment and vigorous self-management. Reinforcement of effective self management and diabetes education are important factors in successful treatment. The aim of this study was to evaluate the effectiveness of the current diabetes education program on blood glucose control, self-management, and self-efficacy of patients with type 2 diabetes mellitus. Methods: A total of 592 patients with newly diagnosed or uncontrolled type 2 diabetes mellitus were recruited to the diabetes education program from January to December 2007. We surveyed 338 patients from April to July 2008. A total of 117 patients had biochemical examinations and completed a questionnaire about knowledge, self-management and self-efficacy of diabetes treatment (no education group (n=23), education group (n=94)). Results: The total scores from the questionnaires and the results of laboratory data showed no differences between the two groups. However, there were significant reductions in hemoglobin A1c level in the education group, as compared with the no education group (P=0.039). Although the score for knowledge about diabetes mellitus was significantly higher in the education group (P=0.005), greater knowledge was not reflected in the self-management or self-efficacy of the patients. Conclusion: The current diabetes education program had no effect on the self-management or self-efficacy of patients with diabetes, although did show some degree of association with blood glucose control and diabetes knowledge level. We conclude that a more effective diabetes education program needs to be developed and applied to daily practice for the improvement of self-efficacy in patients with diabetes mellitus. (Korean Diabetes J 33:518-525, 2009)

The Influence of Type-1 Diabetes Mellitus on Dentition and Oral Health in Children and Adolescents

Recep Orbak,Sera Simsek,Zerrin Orbak,Fahri Kavrut,Meltem Colak 연세대학교의과대학 2008 Yonsei medical journal Vol.49 No.3

Purpose: The present study is to investigate the effects of type 1 diabetes mellitus on dentition and oral health for children and adolescents. Materials and Methods: The investigation was carried out on 100 subjects. The first group consisted of 50 subjects with type 1 diabetes mellitus (21 females, 29 males), age 9±0.14 years; In the second group, there were 50 healthy subjects who did not suffer from any systemic disease (25 females, 25 males), age 9±0.11 years. The subjects were evaluated and divided into two groups of 5-9 years old, and 10-14 years old. The dentition of all participants was examined. Besides, the DFS/dfs index, oral hygiene conditions were evaluated, as well as the plaque index (PI), gingival index (GI) and calculus index (CI). The data obtained from each group were compared statistically. Results: When compared to the non-diabetic group, we observed that dental development was accelerated until the age of 10 in the diabetic group, and there was a delay after the age of 10. The edentulous interval was longer in the group with type 1 diabetes mellitus. This was accompanied by a high ratio of gingival inflammation. Gingival inflammation was 69.7% in the group of 5-9 year-old, and 83.7% in the group of 10-14 year-old with type 1 diabetes mellitus. Though there was a greater loss of teeth in the group with type 1 diabetes mellitus, there were more caries in the control group. The PI, GI and CI values showed an increase with aging in favor of the group with type 1 diabetes mellitus. There was statistically significant difference in PI, GI and CI between the control and type 1 diabetes mellitus groups for 10-14 year-old patients (p<0.001). Conclusion: The findings we obtained showed that type 1 diabetes mellitus plays an important part in the dentition and oral health of children and adolescents.