The purpose of this study was to investigate the characteristics of the lifestyle of our diabetic patients under treatment in our hospital in order to provide them with a more effective education.
  Method:A questionnaire survey was conducted on the diabetics to find their lifestyle. The results were compared with the data on the lifestyle of the general population (GP) in Nagano prefecture, obtained from the 2007 Health and Nutrition Survey in Nagano. The relationship between lifestyle of the diabetics and stages of change model was also examined.
  Results and discussion:The ratio of those who did not have breakfast and ate between meals was larger in our diabetic subjects than the corresponding figure of the GP. Diabetic women in the stage of maintenance ate breakfast more regularly than diabetic women in the other stages. This suggested that it was necessity to recognize the stage of diabetics and to educate them according to the stage. More people in the diabetics were smokers than in the GP, and the frequency was higher in diabetic men in the stage of preparation and maintenance than in the other stages. Therefore, diabetics in the stage of preparation and higher should be advised to quit smoking, if they are smokers. The diabetics seemed to feel stressed less than the GP. Those diabetics who habitually slept less than six hours said that they were under stress. This indicated that there was a possibility of deterioration in blood sugar level, and that sleeping time was one of the important factors. The diabetics did not take less exercise than the GP, especially in diabetic men in the stage of preparation and diabetic women in the stage of pre-contemplation and contemplation. This showed that the diabetics without regular exercise should be aware of the necessity of therapeutic exercise, and require individual programs.

  The purpose of this study was to clarify the current nutritional management of patients receiving home-care services after discharge from Nagano Matsusiro General Hospital and to mull over the future nutritional management in their home.
  A questionnaire survey about nutrition was conducted on 53 home nursing care receivers and rehabilitation program participants.
  Patients with a body mass index of less than 18.5 (low BMI patients) accounted for 39.6%, and the total energy intake was predicted to be lower than necessary for these patients. Therefore, we deemed that it was necessary to calculate their nutritional requirements and evaluate their nutritional status.
  Nutritional evaluation was made in 84.9% of the patients. Weight was seldom measured, especialy among the enteral feeding groups.
  Not measuring weight is known to be related to an unfavorable outcome and hospitalization. Therefore, we thought it necessary to perform somatometry using a nutrition assessment kit, calculate nutritional requirements, and evaluate the nutritional status for risk reduction. Of the 44 patients who were taking food orally, 34.1% had dysphagia, and for 40% of them, there was no specific coping strategy.
  This indicated that dysphagia was not considered to be a major problem. A significantly large number of dysphagia cases were found among low BMI patients.
  For these patients, intervention by a speech therapist, as well as instruction about the risk of aspiration and choking, should be considered.
  There were significantly many a number of users of nutritional supplements among the low BMI patients, but 84.6% of them used products categorized as health foods. This suggested a lack of appropriate information about nutritional supplements. Accurate information should be provided to these patients.
  For nutritional management of home care patients, we concluded that intervention by multiple specialists (including dietitians, speech therapists, and dental hygienists) was necessary. The nutritional support team (NST) should intervene in cooperation with these specialists.