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The Role of Medical Social Worker Engaging in Diabetes Management

Journal of Korean Diabetes.2019;20(4):251-254. doi:10.4093/jkd.2019.20.4.251

Diabetes is a chronic disease that requires patient self-management. Successful self-care by diabetics includes accepting their diabetes status and learning proper diabetes management, as well as creating and maintaining a lifestyle that enables diabetes management.Recently, in order to improve diabetics’ self-care capability, health education has been shared by trained specialists (doctors, nurses, nutritionists, and medical social workers, etc.) through team access. Under these circumstances, the medical social worker acts as a member of the treatment team and plays a role in helping patients’ stabilize treatment and return to society smoothly by training them in psychological, economic, and social issues that make living with diabetes treatment difficult.The purpose of this study was to examine the role of medical social workers engaged in the treatment of diabetics based on their clinical work.
Chronic Disease ; Health Education ; Humans ; Learning ; Life Style ; Nutritionists ; Self Care ; Social Work ; Social Workers ; Specialization

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Ketogenic Diet and Glucose Control

Yeon Hee LEE

Journal of Korean Diabetes.2019;20(4):244-250. doi:10.4093/jkd.2019.20.4.244

There is not a set percentage of calories from carbohydrate, protein, and fat for all people with diabetes. It is recommended that diet be individualized according to each patient's eating patterns, preferences, and metabolic goals. Overweight or obese patients with diabetes could improve their insulin sensitivity, glycemia, blood pressure and dyslipidemia via weight loss. Therefore, various dietary patterns have been tried for weight and glucose control. The Ketogenic diet includes very low-carbohydrate and high fat and is known to be effective for weight loss in a short period of time. Short-term studies have demonstrated the effects of the Ketogenic diet on weight loss and glycemic control improvement, but long-term studies are not yet sufficient. In addition, various side effects such as hypoglycemia and nutritional imbalances are concerns, so there is a lack of evidence with respect to recommending this diet as nutrition therapy for diabetics.
Blood Pressure ; Diet ; Dyslipidemias ; Eating ; Glucose ; Humans ; Hypoglycemia ; Insulin Resistance ; Ketogenic Diet ; Nutrition Therapy ; Overweight ; Weight Loss

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Self-Blood Glucose Management of Diabetes in Pregnancy

Sun Young KIM

Journal of Korean Diabetes.2019;20(4):239-243. doi:10.4093/jkd.2019.20.4.239

The prevalence of gestational diabetes mellitus in Korea was 1.7~3.9% in the 1990s, but it has risen sharply since 2007, reported at 10.5% in 2011, Active prevention and management are needed to help address this continued increase. Several studies have shown that aggressive blood glucose management can reduce maternal and neonatal complications. The American Diabetes Association proposed control of blood glucose level during pregnancy at, less than 95 mg/dL at fasting, less than 140 mg/dL at 1 hour postprandial, and less than 120 mg/dL at 2 hours postprandial. In addition, blood glucose management is necessary for prevention of type 2 diabetes after childbirth.
Blood Glucose ; Diabetes, Gestational ; Fasting ; Female ; Glucose ; Korea ; Parturition ; Pregnancy ; Prevalence

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Management of Cardiovascular Risk Factors in Elderly Diabetes Mellitus Patients

Sung Hoon YU

Journal of Korean Diabetes.2019;20(4):233-238. doi:10.4093/jkd.2019.20.4.233

Tight control of dyslipidemia and hypertension in elderly diabetic patients aged 65 years or older are considered to be very important for the secondary prevention of cardiovascular disease and control of severe diseases associated with macrovascular complications. In addition, in elderly diabetes with risk factors for cardiovascular disease, it is important to control all of the accompanying risk factors together to accomplish the primary prevention of cardiovascular disease. In elderly diabetic patients, thorough control of blood glucose level by itself prevents macrovascular complications. However, it is recommended to perform tight blood glucose control along with other risk factors in consideration of the function and life of the patient. In particular, insulin resistance progresses before the onset of diabetes mellitus and other risk factors for cardiovascular disease. It is important to suppress and prevent the progression of macrovascular complications.
Aged ; Blood Glucose ; Cardiovascular Diseases ; Diabetes Mellitus ; Dyslipidemias ; Humans ; Hypertension ; Insulin Resistance ; Primary Prevention ; Risk Factors ; Secondary Prevention

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Pharmacological Therapy of Diabetes in the Elderly

Junghyun NOH

Journal of Korean Diabetes.2019;20(4):225-232. doi:10.4093/jkd.2019.20.4.225

The prevalence of type 2 diabetes mellitus (T2DM) is expected to increase in the geriatric group with increasing incidence of diabetes with aging and improved life expectancy. Therefore, effective and safe treatment of older T2DM patients is becoming more important in clinical practice. The elderly show heterogeneous individual functional status, and some may have physical handicaps, visual defects, cognitive dysfunction, or psychological disorders such as depression. Therefore, individual approaches depending on presence and progression of geriatric syndromes, comorbidities, and risk of hypoglycemia are important in pharmacological treatment of T2DM in older patients.
Aged ; Aging ; Cognition Disorders ; Comorbidity ; Depression ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Humans ; Hypoglycemia ; Incidence ; Life Expectancy ; Prevalence

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Treatment Goals for Glycemia in Older Patients with Diabetes Mellitus

Jung Ah LIM

Journal of Korean Diabetes.2019;20(4):220-224. doi:10.4093/jkd.2019.20.4.220

More than 25% of Korean population aged ≥ 65 years has diabetes, and elderly diabetic patients show higher mortality, reduced functional activity, and increased risk of hospitalization. The care of elderly diabetic patients is complicated by their clinical, cognitive, and functional heterogeneity. Healthy patients with good functional status can be treated using therapeutic interventions and goals similar those for younger adults with diabetes. For patients with complications and reduced functionality, intensive glycemic control should be avoided. Glycemic goals for older patients might be individualized so that treatment can achieve the appropriate balance between glycemic control and risk of hypoglycemia.
Adult ; Aged ; Diabetes Mellitus ; Hospitalization ; Humans ; Hypoglycemia ; Mortality ; Population Characteristics

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Changes in Glucose Metabolism with Aging

Eun Gyoung HONG

Journal of Korean Diabetes.2019;20(4):215-219. doi:10.4093/jkd.2019.20.4.215

The increasing risk of glucose intolerance and diabetes associated with aging is well established. However, it is difficult to determine whether changes in glucose metabolism result from biological aging itself or due to various environmental factors that occur during the aging process. Many epidemiologic studies have shown that plasma glucose levels after oral glucose tolerance test rise consecutively for every decade of age, but many of these studies also demonstrated the effects of environmental factors including obesity and exercise. In some studies, the development of insulin resistance and insulin secretion defects due to biological aging itself have also been identified as major etiologic factors of glucose intolerance. However, the rate of diabetes development due to these factors is expected to be very slow and largely preventable by addressing environmental risk factors.
Aging ; Blood Glucose ; Carbohydrate Metabolism ; Epidemiologic Studies ; Glucose Intolerance ; Glucose Tolerance Test ; Glucose ; Incretins ; Insulin ; Insulin Resistance ; Metabolism ; Obesity ; Risk Factors

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Gastrointestinal Symptoms in Patients with Diabetes

Mi Kyung KIM

Journal of Korean Diabetes.2019;20(4):210-214. doi:10.4093/jkd.2019.20.4.210

Gastrointestinal symptoms are more common in people with diabetes than in the general population. Patients with diabetes, especially of long duration, have various symptoms such as postprandial fullness, nausea, vomiting, bloating, early satiety, and abdominal pain. These symptoms are related with autonomic abnormalities in gastrointestinal system and leads to reduction of quality of life. In addition, some medications are associated with gastrointestinal symptoms. In this article, I reviewed assessment and management of the gastrointestinal symptoms in diabetes.
Abdominal Pain ; Diabetes Mellitus ; Gastrointestinal Diseases ; Humans ; Nausea ; Quality of Life ; Vomiting

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Metabolic Surgery and Diabetes Mellitus: Its Effects and Side Effects

Mee Kyoung KIM

Journal of Korean Diabetes.2019;20(4):205-209. doi:10.4093/jkd.2019.20.4.205

Recent studies have shown that metabolic surgery can lead to the remission of diabetes mellitus (DM) in a large portion of patients with both type 2 DM and morbid obesity. Metabolic surgery may be considered for glycemic control and weight loss in obese patients with type 2 DM. The most commonly performed bariatric surgeries are sleeve gastrectomy and Roux-en-Y gastric bypass. The effect of metabolic surgery, especially Roux-en-Y gastric bypass, is thought to be caused by mechanisms other than weight loss. Increased insulin secretion associated with altered gut hormones might play a role in this improvement. After metabolic surgery, glucose, lipids, and blood pressure are greatly improved, but not all patients with type 2 DM who undergo metabolic surgery achieve DM remission.
Bariatric Surgery ; Blood Pressure ; Diabetes Mellitus ; Gastrectomy ; Gastric Bypass ; Glucose ; Humans ; Insulin ; Korea ; Obesity, Morbid ; Weight Loss

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Corrigendum: Text Correction: Blood Sugar Control and Low-Carbohydrate High-Fat Diet

Eun Hee KANG

Journal of Korean Diabetes.2019;20(1):62-62. doi:10.4093/jkd.2019.20.1.62

This erratum is being published to correct the text error on page 241 of the article.

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