No abstract available.

No abstract available.

BACKGROUND: Given the nature and chronicity of diabetes mellitus (DM), the role of self care and adequate patient education, in addition to the support of medical professional, is essential in its management. The aim of the present study was to compare the effects of positive messages and negative messages in DM education and to identify the superior method of motivation for self care behaviors. METHODS: A total of 99 DM patients (50 positive message group: 49 negative message group) at Gyeongsang National University Hospital participated in the study. The collected data were analyzed by Chi square and t-test. RESULTS: There were no significant differences in the attitude of messages and in the attitude of self care behaviors between the positive and negative message group, though the negative message group had a significantly higher intention of self care behaviors than did the positive message group. CONCLUSION: These results suggest that the negative messages are more effective than positive messages for increasing the intention of self care behaviors in patients with DM.
Diabetes Mellitus ; Humans ; Intention ; Motivation ; Patient Education as Topic ; Self Care

BACKGROUND: The results of previous studies suggest that portion size is a major factor dictating dietary energy intake. We investigated the relationship between frequencies of rice meals, bowl volumes, and dietary energy intake in a sample of patients with type 2 diabetes. METHODS: A total of 203 type 2 diabetes patients were enrolled in the study. A one-week food diary was collected from each patient and used to assess the types of meal consumed as well as the context of consumption. The volumes of the eating vessels (rice, soup and side dish bowls) used by each patient were obtained by comparisons to measuring cylinders, and dietary energy and macronutrient intake were estimated for each patient by consulting three-day dietary records. RESULTS: The mean age of the 203 subjects (male: 76, female: 127) was 53.9 +/- 9.1 years and the average body mass index (BMI) was 25.6 +/- 4.2 kg/m2. Among the subjects who ate three times per day, 96.4% consumed rice more than twice out of three meals. The median volume of rice bowls used by patients was 350 cc, of soup bowls was 530 cc and of side dish bowls was 260 cc. Portion size, as estimated by rice bowl volume, was not associated with BMI. Male subjects tended to eat out of larger rice and soup bowls (P < 0.001). Portion size was correlated with energy intake from rice (P = 0.021), but not with total energy intake (kcal/kg/day), especially in male subjects. CONCLUSION: Portion size of rice bowl was correlated with energy intake from rice, but not with total energy intake in male subjects with type 2 diabetes. To design effective meal planning methods for patients with type 2 diabetes, further prospective studies are warranted to investigate causative relationships between portion size andmetabolic conditions as well as variation by gender.
Body Mass Index ; Diabetes Mellitus, Type 2 ; Diet, Diabetic ; Diet Records ; Eating ; Energy Intake ; Humans ; Male ; Meals

BACKGROUND: There are many studies regarding the effects of insulin on bone metabolism and changes in bone mineral density (BMD) in the setting of diabetes. The effect of prediabetes on BMD is not known. METHODS: A total of 802 men participated in the Korea Rural Genomic Cohort Study (in Geumsan County). According to the results of an oral glucose tolerance test, subjects were classified into normal, prediabetic, and diabetic categories. One hundred twenty-four subjects diagnosed with type 2 diabetes were excluded, leaving 678 subjects for the study inclusion. BMD was estimated with a quantitative ultrasonometer. RESULTS: The average BMD T scores of normal and prediabetic subjects were -1.34 +/- 1.42 and -1.33 +/- 1.30, respectively; there was no significant difference in the BMD T scores between these groups. The BMD T score was inversely associated with age and positively correlated with body weight, body mass index, total cholesterol, low density lipoprotein cholesterol, and HbA1c. On multiple linear regression analysis, low density lipoprotein cholesterol was the only statistically significant variable for prediabetes (beta = 0.007, P = 0.005). On the stepwise regression analysis, age (beta = -0.026, P < 0.001), the body mass index (beta = 0.079, P < 0.001), and low density lipoprotein cholesterol (beta = 0.004, P = 0.016) were significant variables for prediabetes. CONCLUSIONS: There was no significant difference in the BMD T score between the normal and prediabetic subjects. Further studies are needed regarding the association of fracture risk and changes in BMD with the development of overt diabetes.
Body Mass Index ; Body Weight ; Bone Density ; Cholesterol ; Cholesterol, LDL ; Cohort Studies ; Glucose Tolerance Test ; Humans ; Insulin ; Korea ; Linear Models ; Lipoproteins ; Male ; Prediabetic State

BACKGROUND: Acute postprandial hyperglycemia is an important affector for atherosclerosis in subjects with glucose intolerance. We analyzed the relationship of brachial-ankle pulse wave velocity (baPWV) with fasting and post-challenge plasma glucose levels according to different time points during oral glucose tolerance test (OGTT). METHODS: In 663 subjects with fasting hyperglycemia, 75 g OGTT were performed to confirm the glucose tolerant status, and fasting, post-challenge 30-minute and 120-minute glucose levels were measured. Anthropometric measurements were done, and fasting lipid profiles were measured. baPWV were measured in all subjects and the relationship between fasting, 30- and 120-minute post-challenge glucose levels and baPWV were analyzed. RESULTS: Among the participants, 62.9% were prediabetes and 31.7% were diabetes. Mean baPWV value was significantly higher in subjects with diabetes compared with prediabetes group. In bivariate correlation analyses, age, blood pressure, total cholesterol, low density lipoprotein cholesterol, 30-minute and 120-minute post-challenge glucose levels showed significant positive correlation with baPWV value. In multiple regression analysis, 30-minute post-challenge glucose level was a weak but significant determinant for mean baPWV value even after adjustment for other confounding variables. CONCLUSIONS: Postprandial hyperglycemia, especially 30-minute glucose levels showed significant correlation with baPWV in subjects with fasting hyperglycemia. These results can imply the deleterious effect of acute hyperglycemic excursion on arterial stiffness in subjects with glucose intolerance.
Adult ; Atherosclerosis ; Blood Pressure ; Cholesterol ; Cholesterol, LDL ; Confounding Factors (Epidemiology) ; Fasting ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Lipoproteins ; Plasma ; Prediabetic State ; Pulse Wave Analysis ; Vascular Stiffness

No abstract available.
Hyperglycemia ; Pulse Wave Analysis

In the well-fed state a relatively high activity of the pyruvate dehydrogenase complex (PDC) reduces blood glucose levels by directing the carbon of pyruvate into the citric acid cycle. In the fasted state a relatively low activity of the PDC helps maintain blood glucose levels by conserving pyruvate and other three carbon compounds for gluconeogenesis. The relative activities of the pyruvate dehydrogenase kinases (PDKs) and the opposing pyruvate dehydrogenase phosphatases determine the activity of PDC in the fed and fasted states. Up regulation of PDK4 is largely responsible for inactivation of PDC in the fasted state. PDK4 knockout mice have lower fasting blood glucose levels than wild type mice, proving that up regulation of PDK4 is important for normal glucose homeostasis. In type 2 diabetes, up regulation of PDK4 also inactivates PDC, which promotes gluconeogenesis and thereby contributes to the hyperglycemia characteristic of this disease. When fed a high fat diet, wild type mice develop fasting hyperglycemia but PDK4 knockout mice remain euglycemic, proving that up regulation of PDK4 contributes to hyperglycemia in diabetes. These finding suggest PDK4 inhibitors might prove useful in the treatment of type 2 diabetes.
Animals ; Blood Glucose ; Carbon ; Citric Acid Cycle ; Diet, High-Fat ; Fasting ; Gluconeogenesis ; Glucose ; Homeostasis ; Hyperglycemia ; Ketone Bodies ; Mice ; Mice, Knockout ; Oxidoreductases ; Phosphoric Monoester Hydrolases ; Phosphotransferases ; Protein Kinases ; Protein-Serine-Threonine Kinases ; Pyruvate Dehydrogenase Complex ; Pyruvic Acid ; Up-Regulation

New diabetes management systems based on interactive communication have been introduced recently, accompanying rapid advances in information technology; these systems are referred to as "ubiquitous diabetes management systems." In such ubiquitous systems, patients and medical teams can communicate via Internet or telecommunications, with patients uploading their glucose data and personal information, and medical teams sending optimal feedback. Clinical evidence from both long-term and short-term trials has been reported by some researchers. Such systems appear to be effective not only in reducing the levels of HbA1c but also in stabilizing glucose control. However, most notably, evidence for the cost-effectiveness of such a system should be demonstrated before it can be propagated out to the general population in actual clinical practice. To establish a cost-effective model, various types of clinical decision supporting software designed to reduce the labor time of physicians must first be developed. A number of sensors and devices for monitoring patients' data are expected to be available in the near future; thus, methods for automatic interconnections between devices and web charts were also developed. Further investigations to demonstrate the clinical outcomes of such a system should be conducted, hopefully leading to a new paradigm of diabetes management.
Delivery of Health Care ; Diabetes Mellitus ; Glucose ; Humans ; Internet ; Software Design ; Telecommunications

No abstract available.
Coronary Artery Disease ; Coronary Vessels ; Cystatin C ; Humans