1
|
Byeon H. Developing a nomogram for predicting depression in diabetic patients after COVID-19 using machine learning. Front Public Health 2023; 11:1150818. [PMID: 37533521 PMCID: PMC10390766 DOI: 10.3389/fpubh.2023.1150818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/10/2023] [Indexed: 08/04/2023] Open
Abstract
Objective This study identified major risk factors for depression in community diabetic patients using machine learning techniques and developed predictive models for predicting the high-risk group for depression in diabetic patients based on multiple risk factors. Methods This study analyzed 26,829 adults living in the community who were diagnosed with diabetes by a doctor. The prevalence of a depressive disorder was the dependent variable in this study. This study developed a model for predicting diabetic depression using multiple logistic regression, which corrected all confounding factors in order to identify the relationship (influence) of predictive factors for diabetic depression by entering the top nine variables with high importance, which were identified in CatBoost. Results The prevalence of depression was 22.4% (n = 6,001). This study calculated the importance of factors related to depression in diabetic patients living in South Korean community using CatBoost to find that the top nine variables with high importance were gender, smoking status, changes in drinking before and after the COVID-19 pandemic, changes in smoking before and after the COVID-19 pandemic, subjective health, concern about economic loss due to the COVID-19 pandemic, changes in sleeping hours due to the COVID-19 pandemic, economic activity, and the number of people you can ask for help in a disaster situation such as COVID-19 infection. Conclusion It is necessary to identify the high-risk group for diabetes and depression at an early stage, while considering multiple risk factors, and to seek a personalized psychological support system at the primary medical level, which can improve their mental health.
Collapse
Affiliation(s)
- Haewon Byeon
- Department of Digital Anti-aging Healthcare (BK21), Graduate School of Inje University, Gimhae, Republic of Korea
- Department of Medical Big Data, College of AI Convergence, Inje University, Gimhae, Republic of Korea
| |
Collapse
|
2
|
Byeon H. Factors Influencing the Utilization of Diabetes Complication Tests Under the COVID-19 Pandemic: Machine Learning Approach. Front Endocrinol (Lausanne) 2022; 13:925844. [PMID: 35813626 PMCID: PMC9258727 DOI: 10.3389/fendo.2022.925844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/17/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE There are still not enough studies on the prediction of non-utilization of a complication test or a glycated hemoglobin test for preventing diabetes complications by using large-scale community-based big data. This study identified the ratio of not taking a diabetes complication test (fundus examination and microprotein urination test) among adult diabetic patients over 19 years using a national survey conducted in South Korea and developed a model for predicting the probability of not taking a diabetes complication test based on it. METHODS This study analyzed 25,811 subjects who responded that they had been diagnosed with diabetes by a doctor in the 2020 Community Health Survey. Outcome variables were defined as the utilization of the microprotein urination test and the fundus examination during the past year. This study developed a model for predicting the utilization of a diabetes complication test using logistic regression analysis and nomogram to understand the relationship of predictive factors on the utilization of a diabetes complication test. RESULTS The results of this study confirmed that age, education level, the recognition of own blood glucose level, current diabetes treatment, diabetes management education, not conducting the glycated hemoglobin test in the past year, smoking, single-person household, subjectively good health, and living in the rural area were independently related to the non-utilization of diabetes complication test after the COVID-19 pandemic. CONCLUSION Additional longitudinal studies are required to confirm the causality of the non-utilization of diabetes complication screening tests.
Collapse
Affiliation(s)
- Haewon Byeon
- Department of Digital Anti-aging Healthcare (BK21), Graduate School of Inje University, Gimhae, South Korea
- Department of Medical Big Data, College of AI Convergence, Inje University, Gimhae, South Korea
- *Correspondence: Haewon Byeon,
| |
Collapse
|
3
|
Abstract
Purpose:
The prevalence of diabetes and the personal and national burden from diabetes, a serious health issue around the globe, continues to increase. The purpose of this study was to identify factors influencing self-care among patients with type 2 diabetes.
Methods:
We conducted a cross-sectional descriptive survey of 118 outpatients with type 2 diabetes in national university hospital C in Korea. Data were collected from self-report questionnaires covering information on demographics, self-care, and self-efficacy. Additional data were collected from medical records including information on HbA1c, fasting blood glucose levels, and cholesterol levels. Collected data were analyzed using descriptive statistics, Pearson’s correlation coefficient, and multiple regression using SPSS/WIN version 22.0 software.
Results:
Factors affecting self-care were the following four: self-efficacy, HbA1c, occupation status, and smoking status. Higher engagement in self-care was associated with higher self-efficacy (β = .53, p < .001), lower HbA1c (β = -0.33, p < .001), unemployment (β = -0.20, p < .001), and non-smoking status (β = -0.15, p = .011). The regression model of self-care among the type 2 diabetes patients was statistically significant (F = 67.15, p < .001), and the explanatory power of the adjusted R2 was 69%.
Conclusion:
Type 2 diabetes patients with high self-efficacy and self-care scores showed good glycemic control. Therefore, this finding suggests that nursing interventions should be developed to enhance self-efficacy, which is the greatest influencing factor for self-care.
Collapse
|
4
|
Kim H, Kim S, Han S, Rane PP, Fox KM, Qian Y, Suh HS. Prevalence and incidence of atherosclerotic cardiovascular disease and its risk factors in Korea: a nationwide population-based study. BMC Public Health 2019; 19:1112. [PMID: 31412823 PMCID: PMC6694551 DOI: 10.1186/s12889-019-7439-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/17/2022] Open
Abstract
Background Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in Korea. According to a report of published by Statistics Korea in 2014, cerebrovascular disease and cardiovascular disease were the major/leading causes of mortality. However, it is more difficult to identify prevalence and incidence of a disease than the mortality owing to the lack of national-level statistics. Few studies have examined the prevalence and incidence of ASCVD and its risk factors since 2012. This study aimed to estimate the prevalence and incidence of ASCVD and its risk factors in Korea using national claims data. Methods We conducted a retrospective analysis using the national claims data of the Health Insurance Review and Assessment Service. Patients aged ≥18 years with ASCVD (defined as myocardial infarction, angina, coronary revascularization, peripheral artery disease, ischemic stroke, and transient ischemic attack) were identified between January 1, 2014 and December 31, 2015. Patients at high risk for ASCVD (defined as hypertension, diabetes mellitus, and dyslipidemia without ASCVD during the baseline period) were identified between January 1, 2015 and December 31, 2015. We estimated the prevalence, cumulative incidence, and incidence density. These were further stratified by age and sex. The respective denominators for prevalence and incidence were the census population and the at-risk population (defined as the population without respective disease 1 year prior to the respective disease identification). Results Among the included Korean adult patients, the overall prevalence of clinical ASCVD per 1000 individuals was 98.25 in 2014 and 101.11 in 2015. The respective cumulative incidence and incidence density rates of ASCVD per 1000 individuals were 65.30 and 68.03 in 2014, and 67.05 and 69.94 in 2015, respectively. Peripheral artery disease seemed to drive the increase in the total prevalence and incidence of ASCVD. The prevalence and incidence of ASCVD continued to increase with age until 79 years. Conclusions This national population-based study confirmed the high prevalence and incidence of ASCVD and its risk factors in the adult population of South Korea. We suggest that more intensive treatment and prevention are needed to prevent ASCVD. Electronic supplementary material The online version of this article (10.1186/s12889-019-7439-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hyungtae Kim
- College of Pharmacy, Pusan National University, Busandaehak-ro 63 beon-gil, Busan, South Korea
| | - Siin Kim
- College of Pharmacy, Pusan National University, Busandaehak-ro 63 beon-gil, Busan, South Korea
| | - Sola Han
- College of Pharmacy, Pusan National University, Busandaehak-ro 63 beon-gil, Busan, South Korea
| | | | | | - Yi Qian
- Amgen, Inc, Thousand Oaks, CA, USA
| | - Hae Sun Suh
- College of Pharmacy, Pusan National University, Busandaehak-ro 63 beon-gil, Busan, South Korea.
| |
Collapse
|
5
|
Yang T, Zheng R, Chen Q, Mao Y. Current status of treatment of type 2 diabetes mellitus in Ningbo, China. J Clin Lab Anal 2018; 33:e22717. [PMID: 30461061 DOI: 10.1002/jcla.22717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The treatment status of type 2 diabetes mellitus (T2DM) in Ningbo has not been reported in the past. To evaluate the current status of T2DM in Ningbo and provide evidence to formulate more policies, a multicenter investigation was needed. METHODS The Ningbo Clinical Research Group of Diabetes constituted nine hospitals. Participants included 3015 patients who visited the nine hospitals from June to December 2016. General characteristics, the medication situation, the laboratory indexes in nearly 3 months consisting of glycosylated hemoglobin level (HbA1c), low-density lipoprotein cholesterol (LDL-C), and fasting blood glucose (FBG), and the results of ophthalmologic examination were investigated. The evaluation criteria were defined based on 2013 China guideline for T2DM. RESULTS The 3015 subjects included 1685 men and 1330 women. The average age was 63.3 ± 13.0 years. The prevalence of hypertension and dyslipidemia was 58.7% and 56.7%, respectively. In the examinees, nephropathy appeared in 11.6% and retinopathy in 14.5%. More than half (50.9%) of the subjects were overweight. The achievement rate of blood pressure (BP) was 39.6% (<140/80 mm Hg), FBG was 46.0% (4.4-7.0 mmol/L), HbA1c was 41.7% (<7.0%), and LDL-C was 51.7% (<1.8 mmol/L; and if accompanied by CHD, <2.6). CONCLUSION Ningbo City T2DM status is not optimistic, and there is a big gap with the indicators.
Collapse
Affiliation(s)
- Tianmeng Yang
- Department of Endocrinology, the Affiliated Hospital of Medical School of Ningbo University, Ningbo, China.,Ningbo University School of Medicine, Ningbo, China
| | | | - Qingmei Chen
- Department of Endocrinology, the Affiliated Hospital of Medical School of Ningbo University, Ningbo, China.,Ningbo University School of Medicine, Ningbo, China
| | - Yushan Mao
- Department of Endocrinology, the Affiliated Hospital of Medical School of Ningbo University, Ningbo, China
| | | |
Collapse
|
6
|
Kim HS, Kim H, Yang HK, Lee EY, Jeong YJ, Kim TM, Yang SJ, Baik SY, Lee SH, Cho JH, Choi IY, Yim HW, Cha BY. Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes. Diabetes Metab J 2017; 41:187-194. [PMID: 28537057 PMCID: PMC5489499 DOI: 10.4093/dmj.2017.41.3.187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/18/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels. METHODS The study was conducted between January 2009 and December 2013 and included patients with DM. The glycosylated hemoglobin (HbA1c) levels were evaluated at the first visit and after 3 months. During the first medical examination, a designated doctor also conducted a diabetes education session that mainly covered dietary management. RESULTS Patients were divided into those who received no diabetic medications (n=66) and those who received an OHA (n=124). Education resulted in a marked decrease in HbA1c levels in the OHA group among patients who had DM for <1 year (from 7.0%±1.3% to 6.6%±0.9%, P=0.0092) and for 1 to 5 years (from 7.5%±1.8% to 6.9%±1.1%, P=0.0091). Those with DM >10 years showed a slightly lower HbA1c target achievement rate of <6.5% (odds ratio, 0.089; P=0.0024). CONCLUSION For patients who had DM for more than 5 years, higher doses or changes in medication were more effective than intensive active education. Therefore, individualized and customized education are needed for these patients. For patients with a shorter duration of DM, it may be more effective to provide initial intensive education for diabetes before prescribing medicines, such as OHAs.
Collapse
Affiliation(s)
- Hun Sung Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyunah Kim
- Sookmyung Women's University College of Pharmacy, Seoul, Korea
| | - Hae Kyung Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo Jin Jeong
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Tong Min Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - So Jung Yang
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seo Yeon Baik
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyoung Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - In Young Choi
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bong Yun Cha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| |
Collapse
|
7
|
Yu JH, Kim JS, Lee MR, Yoon SY, Cho SY, Yoo SH, Kim BI. Risks of borderline liver enzyme abnormalities to the incidence of impaired fasting glucose and diabetes mellitus: a 7 year follow up study of workers. Ann Occup Environ Med 2016; 28:18. [PMID: 27057316 PMCID: PMC4823863 DOI: 10.1186/s40557-016-0105-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 03/28/2016] [Indexed: 01/14/2023] Open
Abstract
Background The aim of this study was to identify the relationships between borderline serum liver enzyme abnormalities and the incidence of impaired fasting glucose (IFG) and diabetes mellitus (DM) during a 7-year follow-up of workers, and to evaluate the quantitative level of risks. Methods A total of 749 workers in an electronics manufacturing company were divided into the normal fasting blood glucose (n = 633), IFG (n = 98), and DM (n = 18) groups, according to the results of their health checkup in 2006. Among 633 workers in the normal group, excluding 55 workers who were impossible to follow, incidence rate and relative risks of 578 workers to the IFG or DM in 2013 according to the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (γ-GTP) were investigated. The liver enzyme levels were categorized as A (normal), B (borderline elevation), and R (definite elevation) following the standard of the National Health Insurance Service of Korea. Results The incidence rate of IFG or DM based on ALT level was 9.7 % for the A, 30.0 % for B, and 15.4 % for R. According to γ-GTP, the incidence rate was 9.8 % for A, 34.5 % for B, and 25.0 % for R. The relative risk(RR) to the incidence of IFG or DM depending on the level of ALT were 3.09 in B and 1.59 in R compared to A. According to γ-GTP, RR was 3.52 in B and 2.55 in R compared to A. AST level was not related to the incidence of IFG or DM. A multiple logistic regression analysis with the incidence of IFG or DM as a dependent variable resulted in an odds ratio of 2.664(1.214–5.849) for B level ALT, 3.685(1.405–9.667) for B level of γ-GTP even after adjustment for other variables such as age, sex, body mass index, AUDIT score, systolic blood pressure, and triglyceride. Conclusions Even borderline elevations of ALT and γ-GTP, but not AST, increased the incidence and risk of IFG or DM after 7 years. Borderline elevation of ALT and γ-GTP was identified as an independent risk factor of IFG or DM.
Collapse
Affiliation(s)
- Jin-Hyun Yu
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Jin-Seok Kim
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Mee-Ra Lee
- LIGnex1 Gumi company, 133, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-703 South Korea
| | - Seong-Yong Yoon
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Seong-Yong Cho
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Seung-Hyun Yoo
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| | - Boo-Il Kim
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, 179, Gongdan 1-dong, Gumi-si, Gyeongbuk, 730-706 South Korea
| |
Collapse
|
8
|
Jung JH, Lee JH, Noh JW, Park JE, Kim HS, Yoo JW, Song BR, Lee JR, Hong MH, Jang HM, Na Y, Lee HJ, Lee JM, Kang YG, Kim SY, Sim KH. Current Status of Management in Type 2 Diabetes Mellitus at General Hospitals in South Korea. Diabetes Metab J 2015; 39:307-15. [PMID: 26301192 PMCID: PMC4543194 DOI: 10.4093/dmj.2015.39.4.307] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 10/14/2014] [Indexed: 01/19/2023] Open
Abstract
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/m(2), 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.
Collapse
Affiliation(s)
- Jin-Hee Jung
- Division of Diabetes Education Team, Department of Nursing, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
| | - Jung-Hwa Lee
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jin-Won Noh
- Department of Healthcare Management and Institute of Global Healthcare Research, Eulji University School of Medicine, Seongnam, Korea
| | - Jeong-Eun Park
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Hee-Sook Kim
- Department of Nursing, Dongnam Health University, Suwon, Korea
| | - Joo-Wha Yoo
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Bok-Rye Song
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team , Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong-rim Lee
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myeong-Hee Hong
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hyang-Mi Jang
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Young Na
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun-Joo Lee
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jeong-Mi Lee
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Kwangmyung Sungae Hospital, Gwangmyeong, Korea
| | - Yang-Gyo Kang
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Division of Diabetes Education Team, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Sun-Young Kim
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Diabetes Education Unit, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kang-Hee Sim
- Korea Association of Diabetes Nurse Educators, Seoul, Korea
- Diabetes Education Unit, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
9
|
Choi YJ, Shin DS, Kang M, Bae SS, Kim J. Evaluating Chronic Care of Public Health Centers in a Metropolitan City. HEALTH POLICY AND MANAGEMENT 2014. [DOI: 10.4332/kjhpa.2014.24.4.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
10
|
Suk JH, Lee CW, Son SP, Kim MC, Ahn JH, Lee KJ, Park JY, Shin SH, Kwon MJ, Kim SS, Kim BH, Lee SH, Park JH, Kim IJ. Current status of prescription in type 2 diabetic patients from general hospitals in busan. Diabetes Metab J 2014; 38:230-9. [PMID: 25003077 PMCID: PMC4083030 DOI: 10.4093/dmj.2014.38.3.230] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 10/23/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Data regarding the prescription status of individuals with diabetes are limited. This study was an analysis of participants from the relationship between cardiovascular disease and brachial-ankle pulse wave velocity in patients with type 2 diabetes (REBOUND) Study, which was a prospective multicenter cohort study recruited from eight general hospitals in Busan, Korea. We performed this study to investigate the current status of prescription in Korean type 2 diabetic patients. METHODS Type 2 diabetic patients aged 30 years or more were recruited and data were collected for demographics, medical history, medications, blood pressure, and laboratory tests. RESULTS Three thousands and fifty-eight type 2 diabetic patients were recruited. Mean age, duration of diabetes, and HbA1c were 59 years, 7.6 years, and 7.2%, respectively. Prevalence of hypertension was 66%. Overall, 7.3% of patients were treated with diet and exercise only, 68.2% with oral hypoglycemic agents (OHAs) only, 5.3% with insulin only, and 19.2% with both insulin and OHA. The percentage of patients using antihypertensive, antidyslipidemic, antiplatelet agents was similar as about 60%. The prevalence of statins and aspirin users was 52% and 32%, respectively. CONCLUSION In our study, two thirds of type 2 diabetic patients were treated with OHA only, and one fifth with insulin plus OHA, and 5% with insulin only. More than half of the patients were using each of antihypertensive, antidyslipidemic, or antiplatelet agents. About a half of the patients were treated with statins and one third were treated with aspirin.
Collapse
Affiliation(s)
- Ji Hye Suk
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Woori Medical Clinic, Busan, Korea
| | - Chang Won Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Busan St. Mary's Hospital, Busan, Korea
| | - Sung Pyo Son
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea
| | - Min Cheol Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Ilsin Christian Hospital, Busan, Korea
| | - Jun Hyeob Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Moonhwa Hospital, Busan, Korea
| | - Kwang Jae Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daedong Hospital, Busan, Korea
| | - Ja Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Busan St. Mary's Hospital, Busan, Korea
| | - Sun Hye Shin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bong Seng Memorial Hospital, Busan, Korea
| | - Min Jeong Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Sang Soo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Bo Hyun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Soon Hee Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jeong Hyun Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - In Joo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | | |
Collapse
|
11
|
Lee K, Han J, Kim SG. Increasing risk of diabetes mellitus according to liver function alterations in electronic workers. J Diabetes Investig 2014; 5:671-6. [PMID: 25422767 PMCID: PMC4234230 DOI: 10.1111/jdi.12202] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 12/25/2013] [Accepted: 12/26/2013] [Indexed: 12/20/2022] Open
Abstract
Aims/Introduction We sought to determine the association between change in fasting plasma glucose (FPG) and levels of liver enzymes, such as aspartate transaminase, alanine transaminase and gamma-glutamyltransferase, from health examinations. Materials and Methods A total of 9,393 health screen examinees with no evidence of viral hepatitis, liver diseases, abnormal liver function and diabetes in their past disease history were enrolled in the present study. All the participants underwent three health examinations. Group 1 and 4 were stationary groups of those with normal liver enzyme levels in the first and second health examinations (G1), and abnormal liver enzyme levels in the first and second health check-up (G4). Groups 2 and 3 were altered groups of those with abnormal liver enzyme levels in the first health examination, which became normal in the second health examination (G2), and from a normal liver enzymes level to an abnormal liver enzymes level (G3). Results FPG levels were elevated in male participants (P < 0.01), and were related to old age (P < 0.01), drinking (P < 0.01), smoking (P < 0.01) and so on. There was a strong relationship between FPG levels in the last health examination and altered liver function enzyme levels from the first health examination to the second check-up. In other words, group 4 had the highest level of FPG compared with the other groups (G1 < G2 < G3). Conclusions An association was observed between FPG levels and abnormal liver function in manufacturing workers. Abnormal liver function can be closely associated with the development of diabetes.
Collapse
Affiliation(s)
- Kyoungho Lee
- Samsung Health Research Institute, Samsung Electronics Yongin-City, Korea
| | - Joohee Han
- Samsung Health Research Institute, Samsung Electronics Yongin-City, Korea
| | - Soo-Geun Kim
- Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine Seoul, Korea
| |
Collapse
|
12
|
Kim YJ, Lim MN, Lee DS. Trend Analysis in the Prevalence of Type 2 Diabetes According to Risk Factors among Korean Adults: Based on the 2001~2009 Korean National Health and Nutrition Examination Survey Data. J Korean Acad Nurs 2014; 44:743-50. [DOI: 10.4040/jkan.2014.44.6.743] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Young-Ju Kim
- Department of Statistics, Kangwon National University, Chuncheon, Korea
| | - Myoung-Nam Lim
- Regional Center for Respiratory Disease, Kangwon National University Hospital, Chuncheon, Korea
| | - Dong-Suk Lee
- Department of Nursing, Kangwon National University, Chuncheon, Korea
| |
Collapse
|
13
|
Park IB, Kim J, Kim DJ, Chung CH, Oh JY, Park SW, Lee J, Choi KM, Min KW, Park JH, Son HS, Ahn CW, Kim H, Lee S, Lee IB, Choi I, Baik SH. Diabetes epidemics in Korea: reappraise nationwide survey of diabetes "diabetes in Korea 2007". Diabetes Metab J 2013; 37:233-9. [PMID: 23991400 PMCID: PMC3753487 DOI: 10.4093/dmj.2013.37.4.233] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
There are many studies on the prevalence, clinical characteristics, and economic burden of diabetes across the past four decades in Korea. Nonetheless, there is a dearth of nationwide study regarding diabetes encompassing all age group. Eight years ago, the Committee on the Epidemiology of Diabetes Mellitus of Korean Diabetes Association collaborated with Health Insurance Review & Assessment Service to evaluate the status of diabetes care and characteristics in diabetic patients in Korea. In 2007, the collaborative task force team published a comprehensive survey titled "Diabetes in Korea 2007." In this review, we reappraise the diabetic epidemics from the joint report and suggest further studies that are needed to be investigated in the future.
Collapse
Affiliation(s)
| | - Ie Byung Park
- Department of Endocrinology of Metabolism, Gachon University of Medicine and Science, Incheon, Korea
| | - Jaiyong Kim
- Health Insurance Review & Assessment Service, Seoul, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Choon Hee Chung
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jee-Young Oh
- Division of Endocrinology and Metabolism, Ewha Womans University School of Medicine, Seoul, Korea
| | - Seok Won Park
- Department of Internal Medicine, CHA University, Seongnam, Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Wan Min
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
| | - Jeong Hyun Park
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Hyun Shik Son
- Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea
| | - Chul Woo Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hwayoung Kim
- Health Insurance Review & Assessment Service, Seoul, Korea
| | - Sunhee Lee
- Health Insurance Review & Assessment Service, Seoul, Korea
| | - Im Bong Lee
- Health Insurance Review & Assessment Service, Seoul, Korea
| | - Injeoung Choi
- Health Insurance Review & Assessment Service, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
14
|
Kim MY, Suh S, Jin SM, Kim SW, Bae JC, Hur KY, Kim SH, Rha MY, Cho YY, Lee MS, Lee MK, Kim KW, Kim JH. Education as prescription for patients with type 2 diabetes mellitus: compliance and efficacy in clinical practice. Diabetes Metab J 2012; 36:452-9. [PMID: 23275939 PMCID: PMC3530716 DOI: 10.4093/dmj.2012.36.6.452] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 09/14/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Diabetes self-management education has an important role in diabetes management. The efficacy of education has been proven in several randomized trials. However, the status of diabetes education programs in real Korean clinical practice has not yet been evaluated in terms of patient compliance with the education prescription. METHODS We retrospectively analyzed clinical and laboratory data from all patients who were ordered to undergo diabetes education during 2009 at Samsung Medical Center, Seoul, Korea (n=2,291). After excluding ineligible subjects, 588 patients were included in the analysis. RESULTS Among the 588 patients, 433 received education. The overall compliance rate was 73.6%, which was significantly higher in the subjects with a short duration or living in a rural area compared to those with a long duration (85.0% vs. 65.1%, respectively; P<0.001) or living in an urban area (78.2% vs. 70.4%, respectively; P=0.037). The hemoglobin A1c decreased greater in the compliant group (from 7.84±1.54 at baseline to 6.79±1.06 at 3 months and 6.97±1.20 at 12 months after prescription in the compliant group vs. from 7.74±1.25 to 7.14±1.02 and 7.24±1.24 in the non-compliant group; P=0.001). The decrease in hemoglobin A1c was greater in the subjects with a short duration (P=0.032). CONCLUSION In our study a large percent of patients refuse to get education despite having a prescription from their physician. This refusal rate was higher in the patients with long-standing diabetes or in urban residence. Furthermore, education was more effective in patients with a short duration of diabetes in clinical practice.
Collapse
Affiliation(s)
- Mi Yeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sunghwan Suh
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Won Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Cheol Bae
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Hye Kim
- Department of Dietetics, Samsung Medical Center, Seoul, Korea
| | - Mi Yong Rha
- Department of Dietetics, Samsung Medical Center, Seoul, Korea
| | - Young Yun Cho
- Department of Dietetics, Samsung Medical Center, Seoul, Korea
| | - Myung-Shik Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Kyu Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang-Won Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
15
|
Jeong YM, Kim MY. Comparative Study on HbA1C, Self-care Behavior, and Quality of Life by Depression Status in Type II Diabetic Patients. ACTA ACUST UNITED AC 2012. [DOI: 10.7739/jkafn.2012.19.3.353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
16
|
Kang HM, Kim DJ. Total energy intake may be more associated with glycemic control compared to each proportion of macronutrients in the korean diabetic population. Diabetes Metab J 2012; 36:300-6. [PMID: 22950062 PMCID: PMC3428419 DOI: 10.4093/dmj.2012.36.4.300] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 02/16/2012] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Major macronutrients for energy intake vary among countries and cultures. Carbohydrates, including rice, are the major component of daily energy intake in Korea. The aim of this study was to examine the association of daily energy intake or each proportion of macronutrients, especially carbohydrates, with glycemic control in diabetic Koreans. METHODS A total of 334 individuals with diabetes (175 men, age 57.4±0.8 years; 159 women, age 60.9±0.9 years) who participated in the 2005 Korean National Health and Nutrition Examination Survey were examined. Glycemic control was categorized based on concentration of glycated hemoglobin (HbA1c; HbA1c ≤6.5%; 6.6% to 8.0%; ≥8.1%). Dietary intake was assessed by using a 24-recall item questionnaire. RESULTS High total energy intake was associated with poor glycemic control (HbA1c ≤6.5%, 1,824±75 kcal; 6.6% to 8.0%, 1,990±57 kcal; ≥8.1%, 2,144±73 kcal; P value for trend=0.002). Each proportion of protein, fat, or carbohydrate was not associated with glycemic control. Even after adjusting for several parameters, the association of daily energy intake with glycemic control still persisted. CONCLUSION Total energy intake may be more closely related to glycemic control than each proportionof macronutrients in Korean diabetics.
Collapse
Affiliation(s)
- Hye Mi Kang
- Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Dong-Jun Kim
- Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| |
Collapse
|
17
|
Hwang J, Johnson JA. Relationship between duration of type 2 diabetes and self-reported participation in diabetes education in Korea. Asia Pac J Public Health 2012; 27:NP311-21. [PMID: 22500039 DOI: 10.1177/1010539512440592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The increasing prevalence of diabetes is a pressing issue in Korea. The aim of this study was to determine the relationship between duration of diabetes and self-reported participation in diabetes education among diabetic patients in Korea. This study used data from the Korean National Health and Nutrition Examination Survey in 2005. A total of 1405 respondents older than 19 years and having diabetes were included in the analyses. The relationship between these variables was assessed using logistic regression after adjusting for age, sex, and socioeconomic status. The authors observed that duration of diabetes was associated with having never attended diabetes education programs (odds ratio = 0.95; 95% confidence interval = 0.93-0.96; P < .001), with the greatest risk of not attending seen in recently diagnosed patients. In addition, having lower educational attainment and living in non-Metro Seoul regions were independent factors for never attending diabetes education programs among diabetic patients in Korea. This finding suggests the need for developing effective education programs to encourage diabetic patients, particularly recently diagnosed patients, to participate. Such programs could help deliver appropriate information for diabetes management to all diabetic patients in Korea.
Collapse
|
18
|
Kang AY, Park SK, Park SY, Lee HJ, Han Y, Lee SR, Suh SH, Kim DK, Park MK. Therapeutic target achievement in type 2 diabetic patients after hyperglycemia, hypertension, dyslipidemia management. Diabetes Metab J 2011; 35:264-72. [PMID: 21785747 PMCID: PMC3138102 DOI: 10.4093/dmj.2011.35.3.264] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 12/22/2010] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Our study group established "3H care" in 2002. The meaning of "3H care" attain and maintain adequate controls over hypertension, hyperlipidemia, and hyperglycemia in type 2 diabetic patients. This study evaluated the achievement of target goals after one year or more of "3H care" by specialists in our diabetic clinic. METHODS This was a retrospective study of 200 type 2 diabetic patients who received "3H care" for one year or more in our diabetic clinic. We evaluated achievement of target goals for metabolic controls as suggested by the American Diabetes Association. RESULTS Overall, 200 type 2 diabetes patients were enrolled, of whom 106 were males (53%) and 94 were females (47%). After one year of "3H care," the mean HbA1c was 7.2±1.5% and the percentage of patients achieving glycemic control (HbA1c <7%) was 51.8%. However only 32.2% of hypertensive patients achieved the recommended target. After one year of "3H care," the percentages of those who achieved the target value for dyslipidemia were 80.0% for total cholesterol, 66.3% for low density lipoprotein cholesterol, 57.9% for triglyceride, and 51.8% for high density lipoprotein cholesterol. The percentage that achieved all three targets level was only 4.4% after one year and 14.8% after two years. CONCLUSION The results of this study demonstrate that only a minor proportion of patients with type 2 diabetes achieved the recommended goals despite the implementation of "3H care." It is our suggestion that better treatment strategies and methods should be used to control hypertension, hyperlipidemia and hyperglycemia.
Collapse
Affiliation(s)
- Ah Young Kang
- Department of Internal Medicine, Choon Hae Hospital, Busan, Korea
| | - Su Kyung Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Korea
| | - So Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Korea
| | - Hye Jeong Lee
- Department of Pharmacology, Dong-A University College of Medicine, Busan, Korea
| | - Ying Han
- Diabetes Center, Dong-A University Medical Sciences Research Institute, Busan, Korea
| | - Sa Ra Lee
- Department of Internal Medicine, Sevrance UVA Surgery, Busan, Korea
| | - Sung Hwan Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Duk Kyu Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Korea
- Diabetes Center, Dong-A University Medical Sciences Research Institute, Busan, Korea
| | - Mi Kyoung Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dong-A University Medical Center, Busan, Korea
- Diabetes Center, Dong-A University Medical Sciences Research Institute, Busan, Korea
| |
Collapse
|
19
|
Kim HY, Yun WJ, Shin MH, Kweon SS, Ahn HR, Choi SW, Lee YH, Cho DH, Rhee JA. [Management of diabetic mellitus in low-income rural patients]. J Prev Med Public Health 2009; 42:315-22. [PMID: 19806004 DOI: 10.3961/jpmph.2009.42.5.315] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Knowledge about the management status of diabetic mellitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. METHODS We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. ankle-brachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. RESULTS The age of diabetic subjects was 68.7+/-8.7 years and the duration of diabetes was 8.9+/-8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. CONCLUSIONS DM management in low income patients is very poor and requires further work to improve.
Collapse
Affiliation(s)
- Hye Yeon Kim
- Department of Preventive Medicine, Chonnam National University Medical School
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Lee JS, Kim J, Baik SH, Park IB, Lee J. [An evaluation of sampling design for estimating an epidemiologic volume of diabetes and for assessing present status of its control in Korea]. J Prev Med Public Health 2009; 42:135-42. [PMID: 19349744 DOI: 10.3961/jpmph.2009.42.2.135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES An appropriate sampling strategy for estimating an epidemiologic volume of diabetes has been evaluated through a simulation. METHODS We analyzed about 250 million medical insurance claims data submitted to the Health Insurance Review & Assessment Service with diabetes as principal or subsequent diagnoses, more than or equal to once per year, in 2003. The database was re-constructed to a 'patient-hospital profile' that had 3,676,164 cases, and then to a 'patient profile' that consisted of 2,412,082 observations. The patient profile data was then used to test the validity of a proposed sampling frame and methods of sampling to develop diabetic-related epidemiologic indices. RESULTS Simulation study showed that a use of a stratified two-stage cluster sampling design with a total sample size of 4,000 will provide an estimate of 57.04% (95% prediction range, 49.83 - 64.24%) for a treatment prescription rate of diabetes. The proposed sampling design consists, at first, stratifying the area of the nation into "metropolitan/city/county" and the types of hospital into "tertiary/secondary/primary/clinic" with a proportion of 5:10:10:75. Hospitals were then randomly selected within the strata as a primary sampling unit, followed by a random selection of patients within the hospitals as a secondly sampling unit. The difference between the estimate and the parameter value was projected to be less than 0.3%. CONCLUSIONS The sampling scheme proposed will be applied to a subsequent nationwide field survey not only for estimating the epidemiologic volume of diabetes but also for assessing the present status of nationwide diabetes control.
Collapse
Affiliation(s)
- Ji-Sung Lee
- Department of Public Health, Korea University Graduate School, Korea
| | | | | | | | | |
Collapse
|
21
|
Ahn HJ, Koo BK, Jung JY, Kwon HR, Kim HJ, Park KS, Han KA, Min KW. Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Dietary Intake Control in Korean Type 2 Diabetic Patients. KOREAN DIABETES JOURNAL 2009. [DOI: 10.4093/kdj.2009.33.2.155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Boo-Kyung Koo
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | | | | | - Hyun-Jin Kim
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Kang-Seo Park
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Kyung-Ah Han
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Kyung-Wan Min
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| |
Collapse
|
22
|
Lee YS. The Current Status of Type 2 Diabetes Management at a University Hospital. KOREAN DIABETES JOURNAL 2009. [DOI: 10.4093/kdj.2009.33.3.241] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Young Sil Lee
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea
| |
Collapse
|
23
|
Kim TY, Kim DH, Park CH, Cho KH, Lee SH, Ga H, Kim HC. The Effect of Gamma-Glutamyltransferase on Impaired Fasting Glucose or Type 2 Diabetes in Korean Men. KOREAN DIABETES JOURNAL 2009. [DOI: 10.4093/kdj.2009.33.3.215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Tae-Yeon Kim
- Department of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Do-Hoon Kim
- Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chang-Hae Park
- Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Hwan Cho
- Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seung-Hwan Lee
- Department of Family Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyuk Ga
- Institute of Geriatric Medicine, Eun-Hye Hospital, Korea
| | - Hwan-cheol Kim
- Department of Occupational Medicine, Anam Hospital, Inha University College of Medicine, Incheon, Korea
| |
Collapse
|
24
|
Park CH, Ga H, Leem JH, Kwak SM, Kim HC, Choi JH. [The effect of smoking status upon occurrence of impaired fasting glucose or type 2 diabetes in Korean men]. J Prev Med Public Health 2008; 41:249-54. [PMID: 18664731 DOI: 10.3961/jpmph.2008.41.4.249] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To investigate whether smoking and the smoking status are predictors of the incident impaired fasting glucose (IFG) or type 2 diabetes in Korean men. METHODS A cohort of 1,717 Korean men without IFG or diabetes, who underwent annual periodic health examinations for 4 years (2002-2006), were retrospectively investigated. IFG and diabetes were defined as a serum fasting glucose concentration of 100-125 mg/dL and more than 126 mg/dL, respectively. Cox's proportional hazards model was used to evaluate the association between smoking and development of IFG or type 2 diabetes. RESULTS A total of 558 cases (32.5%) of incident IFG and 50 cases (2.9%) of diabetes occurred. After controlling for the potential predictors of diabetes, the relative risk for IFG, compared with the never smokers, was 1.02 (95% CI=0.88 to 1.19) for the ever-smokers, 0.96 (95% CI=0.79-1.16) for those who smoked 1-9 cigarettes/d, 1.15 (95% CI=1.01 to 1.30) for those who smoked 10-19 cigarettes/d, and 1.31 (95% CI=1.10 to 1.57) for those who smoked 20 or more cigarettes/d (the P value for the current smokers was only p<0.002). The respective multivariate adjusted relative risks for type 2 diabetes, compared with the never-smokers, were 1.07 (95% CI=0.64 to 1.92), 1.47 (95% CI=0.71 to 3.04), 1.84 (95% CI=0.92-3.04), and 1.87 (95% CI=1.13-3.67), respectively (the P value for the current smokers was only p=0.004). CONCLUSIONS The smoking status and the number of cigarettes smoked daily are associated with an increased risk for developing IFG or type 2 diabetes in Korean men.
Collapse
Affiliation(s)
- Chang-Hae Park
- Department of Family Medicine, Inha University College of Medicine
| | | | | | | | | | | |
Collapse
|