BACKGROUND/OBJECTIVES: Metabolic risk factors should be managed effectively in patients with type 2 diabetes mellitus (T2DM) to prevent or delay diabetic complications. This study aimed to compare the self-management levels of diet and metabolic risk factors in patients with T2DM, according to the duration of illness, and to examine the trends in self-management levels during the recent decades. SUBJECTS/METHODS: Data were collected from the Korea National Health and Nutrition Examination Surveys (KNHANES, 1998–2014). In our analysis, 4,148 patients with T2DM, aged ≥ 30 years, were categorized according to the duration of their illness (< 5 years, 5–9 years, and ≥ 10 years). Demographic and lifestyle information was assessed through self-administered questionnaires, and biomarker levels (e.g., fasting glucose level, blood pressure, or lipid level) were obtained from a health examination. Dietary intake was assessed by a 24-recall, and adherence level to dietary guidelines (meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol) were assessed. Multivariable generalized linear regression and unconditional logistic regression models were used to compare the prevalence rates of hyperglycemia, dyslipidemia, and hypertension according to the duration of patients' illness, accounting for the complex survey design of the KNHANES. RESULTS: In the multivariable adjusted models, patients with a longer duration (≥ 10 years) of T2DM had a higher prevalence of hyperglycemia than those with a shorter duration of T2DM (< 5 years) (odds ratio 2.20, 95% confidence interval 1.61–3.01, P for trend < 0.001). We did not observe any associations of disease duration with the prevalence of hypertension and dyslipidemia. In addition, the adherence levels to dietary recommendations did not significantly differ according to disease duration, except adherence to moderate alcohol consumption. There were significant decreasing trends in the prevalence of hyperglycemia in patients with a duration of illness ≥ 10 years (P for trend = 0.004). CONCLUSION: Although the proportion of patients with adequate control of glucose levels has improved in recent decades, poorer self-management has been found in those with a longer disease duration. These findings suggest the need for well-planned and individualized patient education programs to improve self-management levels and quality of life by preventing or delaying diabetic complications.
Alcohol Drinking ; Blood Pressure ; Carbohydrates ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diet ; Dyslipidemias ; Fasting ; Glucose ; Humans ; Hyperglycemia ; Hypertension ; Korea ; Life Style ; Linear Models ; Logistic Models ; Nutrition Policy ; Patient Education as Topic ; Prevalence ; Quality of Life ; Risk Factors ; Self Care ; Sodium

BACKGROUND: The eating habits of Jeju Island natives are quite different from those of the mainland people because of geographic isolation. Diet is a main factor affecting gallstone disease. We investigated the prevalence of gallstone disease in both Jeju Island natives and migrants and studied the risk factors affecting gallstone disease in the Jeju Island people. METHODS: A total of 20,763 subjects who underwent medical checkups at the Health Promotion Center of Jeju National University Hospital in Korea from January 2003 to December 2015 were enrolled in the study. Ultrasonography was used to determine the presence of gallbladder stones. Body mass index and biochemical parameters, including liver function test results, lipid profiles, and fasting blood glucose levels, were verified, and data on age, birthplace, and sex were collected from medical records. Univariate and multivariate analyses were performed to identify risk factors affecting gallstone disease. RESULTS: The prevalence of gallstone disease in the Jeju Island people was 4.0%: Jeju Island natives, 3.8% and migrants, 4.4% (P=0.047). After multivariate logistic regression analysis, the independent risk factors were older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower high-density lipoprotein cholesterol levels. CONCLUSION: The prevalence of gallstone disease was significantly lower in natives than in migrants from Jeju Island. Older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower high-density lipoprotein cholesterol levels contributed to gallstone disease prevalence in the Jeju Island people.
Alanine Transaminase ; Alcohol Drinking ; Blood Glucose ; Body Mass Index ; Cholesterol ; Diet ; Dietary Carbohydrates ; Eating ; Fasting ; Gallbladder ; Gallstones* ; Health Promotion ; Humans ; Korea ; Lipoproteins ; Liver Function Tests ; Logistic Models ; Medical Records ; Multivariate Analysis ; Population Groups* ; Prevalence* ; Risk Factors ; Transients and Migrants* ; Ultrasonography

This study aimed to compare the effects of activity-based personalized nutrition education (APNE) with a general instruction for diabetes (control, CTRL) in middle-aged and older Korean outpatients with type 2 diabetes. After an initial screening, 70 subjects were randomly assigned to APNE (n = 37) or CTRL (n = 33) group. APNE considered each patient’s anthropometry, blood chemistry data, and dietary habits in addition to planning meal choices with the aid of registered dietitians. After 3 months, dietary behavior, food intake, and anthropometric and blood measurement results were evaluated. Fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels decreased in the APNE group (n = 33) but not in the CTRL group (n = 23). In the APNE group, the meal intervals and number of days of consuming high-fat food were decreased, while the number of days following a meal plan and balanced diet that entailed consuming fruits, vegetables, and healthy food was increased. A lower consumption of carbohydrates, saccharides, grains, and tuber crops and a higher protein, pulses, and fat-derived calorie intake compared with the initial values were observed in the APNE group. In contrast, only the number of days following the meal plan and balanced diet was increased in the CRTL group, without significantly changing the individual macronutrient-derived calorie intake. The APNE approach appeared to effectively educate outpatients with type 2 diabetes about changing their dietary behavior and food intake and improving the clinical parameters related to diabetic conditions.
Anthropometry ; Blood Glucose ; Carbohydrates ; Chemistry ; Diet ; Eating ; Education* ; Fasting ; Food Habits ; Fruit ; Hemoglobin A, Glycosylated ; Humans ; Mass Screening ; Meals ; Nutritionists ; Outpatients* ; Vegetables

OBJECTIVE: Traditional Japanese food appears to be healthy but contains a small amount of milk products. Type 2 diabetes (T2DM) patients commonly reduce their energy intake to control their blood glucose levels. However, nutritional guidance for diabetes does not emphasize calcium (Ca) consumption. The aim of this study is to estimate the nutritional status of Ca and other nutrients, which affect bone and Ca metabolism, in T2DM patients. METHODS: This observational study was conducted with Japanese T2DM patients (n = 96; M/F = 50/46; age: 61.6 ± 10.1 years). We estimated nutrient intake using a simple food frequency questionnaire. RESULTS: Median total energy intake was 1750 kcal/day (1440-1970). Their median daily intake of Ca, vitamin D, and vitamin K was 451 mg (336-560), 10.2 µg (8.5-12), and 206 µg (84-261), respectively. Only 17.7% of the study subjects were found to take more than 600 mg/day of Ca. Protein and salt intake was 78 (64-90) and 10.6 (9.3-12.2) g/day, respectively. Male subjects had more salt, less Ca and vitamin K than female. Daily Ca intake was positively associated with total energy, protein, and lipid intake but not with carbohydrates. Vitamin D intake correlated only with protein intake. CONCLUSION: The daily Ca intake of Japanese T2DM patients appears to be insufficient and could depend on protein and lipid intake. Additionally, these patients should have specific recommendations to ensure sufficient intake of Ca with protein and lipid during energy restriction.
Asian Continental Ancestry Group* ; Blood Glucose ; Calcium* ; Carbohydrates ; Energy Intake ; Female ; Humans ; Male ; Metabolism ; Milk ; Nutritional Status* ; Observational Study ; Vitamin D ; Vitamin K

BACKGROUND/OBJECTIVES: This study was conducted to compare the overall changes in dietary intake and metabolic syndrome risk parameters in Vietnamese marriage-based female immigrants over time. SUBJECTS/METHODS: The subjects of this study were 581 Vietnamese marriage-based female immigrants, who were recruited from local clinical centers in Korea. Baseline data were collected from 2006-2011 and the follow-up data were collected from 2012-2014. Dietary food intake was assessed by a 1-day 24-hour recall method. RESULTS: Compared to the baseline, the mean body weight, body mass index, waist circumference, high density lipoprotein (HDL)-cholesterol, systolic blood pressure and diastolic blood pressure increased while the fasting blood sugar, triglycerides and low density lipoprotein-cholesterol decreased at follow-up. The total consumption of foods such as vegetables/fruits/seaweeds/mushrooms, oil and fat, and eggs decreased during the follow-up period, whereas the consumption of sugars, beverages and meats increased. Partial correlation between the rate of change [(Follow-up - Baseline) / Baseline × 100] in metabolic syndrome risk parameters and food intake after controlling for confounding factors showed that the waist circumference was positively correlated with either the total plant food intake (r = 0.1042, P = 0.0129) or the total food intake (r = 0.0880, P = 0.0359). The plasma levels of total cholesterol (r = -0.1918, P = 0.0289) and HDL-cholesterol (r = -0.1424, P = 0.0007) were negatively correlated with the percentage of total intake from plant food, and HDL-cholesterol levels were positively correlated with the intake of total animal food (r = 0.0980, P = 0.0217). The serum C-reactive protein levels were positively correlated with the total intake of animal food (r = 0.2374, P < 0.0001) or the percentage of total intake from animal food (r = 0.1346, P = 0.0016). CONCLUSIONS: These results suggest that the change rate of dietary intake such as total plant food or animal food is associated with the change rates of metabolic syndrome risk parameters.
Animals ; Asian Continental Ancestry Group* ; Beverages ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Body Weight ; C-Reactive Protein ; Carbohydrates ; Cholesterol ; Eating ; Eggs ; Emigrants and Immigrants* ; Fasting ; Female* ; Follow-Up Studies* ; Humans ; Korea* ; Lipoproteins ; Marriage* ; Meat ; Methods ; Ovum ; Plants ; Plasma ; Triglycerides ; Waist Circumference

BACKGROUND/OBJECTIVES: This study was conducted to compare the overall changes in dietary intake and metabolic syndrome risk parameters in Vietnamese marriage-based female immigrants over time. SUBJECTS/METHODS: The subjects of this study were 581 Vietnamese marriage-based female immigrants, who were recruited from local clinical centers in Korea. Baseline data were collected from 2006-2011 and the follow-up data were collected from 2012-2014. Dietary food intake was assessed by a 1-day 24-hour recall method. RESULTS: Compared to the baseline, the mean body weight, body mass index, waist circumference, high density lipoprotein (HDL)-cholesterol, systolic blood pressure and diastolic blood pressure increased while the fasting blood sugar, triglycerides and low density lipoprotein-cholesterol decreased at follow-up. The total consumption of foods such as vegetables/fruits/seaweeds/mushrooms, oil and fat, and eggs decreased during the follow-up period, whereas the consumption of sugars, beverages and meats increased. Partial correlation between the rate of change [(Follow-up - Baseline) / Baseline × 100] in metabolic syndrome risk parameters and food intake after controlling for confounding factors showed that the waist circumference was positively correlated with either the total plant food intake (r = 0.1042, P = 0.0129) or the total food intake (r = 0.0880, P = 0.0359). The plasma levels of total cholesterol (r = -0.1918, P = 0.0289) and HDL-cholesterol (r = -0.1424, P = 0.0007) were negatively correlated with the percentage of total intake from plant food, and HDL-cholesterol levels were positively correlated with the intake of total animal food (r = 0.0980, P = 0.0217). The serum C-reactive protein levels were positively correlated with the total intake of animal food (r = 0.2374, P < 0.0001) or the percentage of total intake from animal food (r = 0.1346, P = 0.0016). CONCLUSIONS: These results suggest that the change rate of dietary intake such as total plant food or animal food is associated with the change rates of metabolic syndrome risk parameters.
Animals ; Asian Continental Ancestry Group* ; Beverages ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Body Weight ; C-Reactive Protein ; Carbohydrates ; Cholesterol ; Eating ; Eggs ; Emigrants and Immigrants* ; Fasting ; Female* ; Follow-Up Studies* ; Humans ; Korea* ; Lipoproteins ; Marriage* ; Meat ; Methods ; Ovum ; Plants ; Plasma ; Triglycerides ; Waist Circumference

Osteoporosis is a major health problem that can lead to mortality. This study was conducted to estimate the prevalence of osteopenia and osteoporosis separately and to assess the risk factors associated with osteopenia/osteoporosis in Korean men aged 50 years and over. A total of 1,136 subjects were analyzed among the participants of the Korea National Health and Nutrition Examination Survey (KNHANES) 2010~2011 by using SPSS statistics complex samples (windows ver. 23.0). The prevalence rates of osteopenia and osteoporosis were 46.3% and 7.3%, respectively, and the mean ages of both osteopenia and osteoporosis risk groups were significantly higher than that of the normal group. The mean values for lifetime tallest height and bone mineral density in whole body, total femur, femoral neck, and lumbar spine were significantly lower in the risk group (osteopenia/osteoporosis) than in the normal group, whereas the mean values for height, body weight, BMI, waist circumference, alkaline phosphatase, parathyroid hormone, fasting blood glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides of the two groups showed no significant differences. The intakes of energy and carbohydrates were significantly higher in the risk group than in the normal group. The results of multiple logistic regression showed that being underweight and having hypercholesterolemia were significantly related with the prevalence of osteopenia/osteoporosis, whereas health habits such as smoking and exercise, chronic diseases such as obesity and hypertension, and nutrient intakes were not. These findings suggest the need for further studies to examine osteopenia/osteoporosis risk factors and outcomes specificly focused on Korean men.
Alkaline Phosphatase ; Blood Glucose ; Body Height ; Bone Density ; Bone Diseases, Metabolic ; Carbohydrates ; Cholesterol ; Chronic Disease ; Fasting ; Femur ; Femur Neck ; Humans ; Hypercholesterolemia ; Hypertension ; Korea* ; Logistic Models ; Male ; Mortality ; Nutrition Surveys* ; Obesity ; Osteoporosis ; Parathyroid Hormone ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Spine ; Thinness ; Triglycerides ; Waist Circumference

PURPOSE: The objective of this study was to compare the effects of three different levels of xylobiose containing sucrose on glycemic indices based on oral glucose tolerance test (OGTT) and blood glucose response in healthy adults. METHODS: Healthy adults (six male and five female participants, n = 11) underwent 14~16 hr of fasting. Subsequently, all participants took 50 g of available carbohydrates from glucose, sucrose containing 7% xylobiose (XB 7), sucrose containing 10% xylobiose (XB 10), or sucrose containing 14% xylobiose (XB 14) every week on the same day for 8 weeks. Finger prick blood was taken before and 15, 30, 45, 60, 90, and 120 min after starting to eat. RESULTS: We observed reduction of the glycemic response to sucrose containing xylobiose. The glycemic indices of XB 7, XB 10, and XB 14 were 57.0, 53.6, and 49.7, respectively. The GI values of XB 7 were similar to those of foods with medium GI, and the GI values of XB 10 and XB 14 were similar to those of foods with low GI. The postprandial maximum blood glucose rise (Cmax) of XB 14 was the lowest among the test foods. XB 7, XB 10, and XB 14 showed significantly lower areas under the glucose curve (AUC) for 0~30 min, 0~60 min, 0~90 min and 0~120 min compared to glucose. CONCLUSION: The results of this study suggest that sucrose containing xylobiose has an acute suppressive effect on GI and postprandial maximum blood glucose rise. In addition, levels of xylobiose in sugar may allow more precise assessment of carbohydrate tolerance despite lower glycemic responses in a dose-dependent manner.
Adult* ; Blood Glucose* ; Carbohydrates ; Fasting ; Female ; Fingers ; Glucose ; Glucose Tolerance Test ; Glycemic Index* ; Humans ; Male ; Sucrose

Glucocorticoids are the most common cause of drug-induced diabetes mellitus or hyperglycemia. Hyperglycemic hyperosmolar syndrome (HHS) secondary to glucocorticoid treatment in patients with glomerular disease has rarely been reported in Korea. This paper describes a case of HHS after corticosteroid administration for the treatment of immunoglobulin A (IgA) nephropathy. A 56-year-old nondiabetic male with biopsy-proven IgA nephropathy was started on a combination therapy of an angiotensin converting enzyme inhibitor and oral prednisolone (60 mg, 0.8 mg/kg/day). Eight weeks after the initiation of steroid therapy, he was admitted with a one-week history of polydipsia, polyuria and general weakness. His laboratory tests revealed a serum creatinine level of 2.7 mg/dL, elevated blood glucose (1,221 mg/dL) and an increase in serum osmolarity (347 mOsm/kg H2O). Urinalysis showed 4+ sugars, 2+ proteins, and negative ketones. Prednisolone was tapered and he was administered with intravenous fluids, insulin and electrolytes. The patient was discharged with normoglycemia without the use of antidiabetic medications on the 18th hospital day. Patients who are taking corticosteroids for the treatment of primary glomerulopathy should be investigated for HHS promptly if they present with dehydration, general weakness and weight loss.
Adrenal Cortex Hormones ; Blood Glucose ; Carbohydrates ; Creatinine ; Dehydration ; Diabetes Mellitus ; Electrolytes ; Glomerulonephritis, IGA* ; Glucocorticoids ; Humans ; Hyperglycemia ; Immunoglobulin A* ; Insulin ; Ketones ; Korea ; Male ; Middle Aged ; Osmolar Concentration ; Peptidyl-Dipeptidase A ; Polydipsia ; Polyuria ; Prednisolone ; Steroids ; Urinalysis ; Weight Loss

Chronic gastritis is a prevalent gastroentestinal disease in Korea. The purpose of this study was to investigate status of foods and nutrients intake and health related biochemical indicators in the patients with chronic gastritis. Daily food and nutrient intake, blood lipids, and antioxidant indicators in the urine, were compared between a group of 19 patients diagnosed with chronic gastritis and a control group of 27 subjects having normal gastroscopy. No significant differences were found in age, height, weight, body mass index, and blood pressure between the two groups. Daily energy intakes were 1900.6 kcal for the chronic gastritis patient group, and 1931.8 kcal for the normal control group without significant difference. No significant difference was found between the two groups in all nutrient intakes except for cholesterol. The chronic gastritis patients consumed lower amount of sugars and sweeteners but greater amount of starchy food groups such as potatoes and legumes than subjects of control group consumed. Also the chronic gastritis patients showed higher serum triglyceride concentration than the normal subjects. These results indicate that the dietary pattern of chronic gastritis patients may have relation to a change in the serum lipid level; however, more systematic research with a larger samples size is required.
Blood Pressure ; Body Weight ; Carbohydrates ; Cholesterol ; Eating ; Fabaceae ; Gastritis* ; Gastroscopy ; Humans ; Korea ; Solanum tuberosum ; Sweetening Agents ; Triglycerides