PURPOSE: The aim of this study is to observe glycemic changes after emphasizing the importance of lifestyle modification in patients with mild or moderately uncontrolled type 2 diabetes. MATERIALS AND METHODS: We examined 51 type 2 diabetic patients with 7.0-9.0% hemoglobin A1c (HbA1c) who preferred to change their lifestyle rather than followed the recommendation of medication change. At the enrollment, the study subjects completed questionnaires about diet and exercise. After 3 months, HbA1c levels were determined and questionnaires on the change of lifestyle were accomplished. We divided the study subjects into 3 groups: improved (more than 0.3% decrease of HbA1c), aggravated (more than 0.3% increase of HbA1c) and not changed (-0.3% diet and exercise for 3 months, compared with the one obtained from patients who refused this lifestyle change (p=0.002). CONCLUSION: In this study, 35.3% of the patients with mild or moderately uncontrolled type 2 diabetes showed the significant improvement of HbA1c levels after 3 months by simply regulating their daily diet and exercise without change of medication. This suggests that the lifestyle modification is significantly associated with the improvement of glucose control.
Aged ; Blood Glucose ; Diabetes Mellitus, Type 2/drug therapy/psychology/*therapy ; *Diet ; *Exercise ; Female ; Hemoglobin A, Glycosylated/metabolism ; Humans ; *Life Style ; Male ; Middle Aged ; Patient Compliance

PURPOSE: The purpose of this study was to explore adult diabetics' eating styles and factors which influence them. METHOD: The study adopted an ethnographic method based on a perspective which views the eating style as a cultural phenomenon. Data was collected through a personal interview, participant observation, and documented materials from Oct.2001 to Sept. 2002. In this study, fifteen adult diabetics, with an average age of 57, participated. Data analysis was done by the Spradley's taxonomic analysis technique. RESULT: The patients' eating styles were rooted in their viewpoint on illness as well as the meaning of food. Eating styles were classified into 4 types: Pathology-centered, symptom-centered, need-centered, and role-centered. CONCLUSION: A conventional approach to the treatment and management of diabetes did not consider the patient's inner world which may play an important role in the successful management of the disease. We found that it was critical for health care personnel to understand patients' values, beliefs and their way of life in order to facilitate the most successful self-care diet.
Middle Aged ; Male ; Korea ; Humans ; *Food Habits ; Female ; *Eating ; Diabetes Mellitus, Type 2/*diet therapy/nursing/psychology ; Culture ; *Attitude to Health ; Aged

PURPOSE: This study was to evaluate the effects of a comprehensive life style modification program on glycemic control and stress response in type 2 diabetes. METHOD: The participants(n=34) with type 2 diabetes were divided into either a usual care(control) or treatment(experimental) group. The experimental group(n=21) received a program that was based on a comprehensive life style modification protocol at a weekly meeting for 16 weeks. They also participated in individually prescribed exercise and diet along with stress management and self monitoring. The participants were followed for 6 months, during which postprandial glucose, HbA1C, and stress response inventory were measured. RESULT: The experimental group showed a significant lower postprandial glucose and stress response compared to those of the control group. However, there was no significant change in the HbA1C value in either group. CONCLUSIONS: These results suggest that a type 2 diabetes comprehensive lifestyle modification program may lead to clinical improvement in glycemic control and reduce the stress response.
Aged ; Counseling/*methods ; Demography ; Diabetes Mellitus, Type 2/diet therapy/psychology/*therapy ; Dietary Sucrose/*therapeutic use ; Female ; Hemoglobin A, Glycosylated/metabolism ; Humans ; Life Style ; Male ; Middle Aged ; Multivariate Analysis ; Program Evaluation ; Stress, Psychological/*therapy

OBJECTIVE: To investigate the self-management behaviors of patients with type 2 diabetes mellitus (DM) in a community and to explore the relationship between self-management behaviors and the glycemic control. METHODS: A total of 211 type 2 DM patients in a community were selected by stratified random sampling. Patients were grouped according to the scores of self-management behaviors. The fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG) and glycated hemoglobin (HbA1C) level were tested. The differences between groups and relationship between self-management behaviors and glycemic control were analyzed. RESULTS: Self-management behaviors of most patients were not effective, and 2hPG and HbA1C were affected by different levels of the self-management behaviors (P<0.05). The self-management behaviors were negatively related to FPG (r=-0.277, P=0.015), 2hPG (r=-0.453, P=0.001), and HbA1C (r=-0.435, P=0.001). Glycemic control of the patients whose course of disease was over 5 years was significantly different due to different self-management behaviors. FPG level of the patients was positively related to alimentary control. The 2hPG level of the patients was positively related to alimentary control, medication persistence, and blood glucose self-monitoring. The HbA1C level of the patients was positively related to alimentary control and medication persistence. The times the patients received DM education, the way to use insulin, and the disease course of the patients were important factors to affect self-management behaviors of type 2 DM in the community. CONCLUSION Self-management behaviors of type 2 DM patients in the community are not effective. Satisfactory self-management behaviors, specially the control of 2hPG and HbA1C are beneficial to glycemic control. We can improve the self-management behaviors in type 2 DM patients by paying attention to the disease course, the treatment method, and the contents and effect of DM education.
Adult ; Aged ; Aged, 80 and over ; Attitude to Health ; Blood Glucose ; metabolism ; Blood Glucose Self-Monitoring ; statistics & numerical data ; China ; Community Networks ; Diabetes Mellitus, Type 2 ; blood ; psychology ; therapy ; Diet, Diabetic ; methods ; psychology ; Female ; Glycated Hemoglobin A ; analysis ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Self Care ; methods ; psychology ; Surveys and Questionnaires ; Young Adult