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- [English]
- Health-related quality of life and nutrient intake of the elderly with type 2 diabetes according to comorbidity burden: a cross-sectional study
- Yejung Choi, Kyong Park
- Korean J Community Nutr 2024;29(5):418-430. Published online October 31, 2024
- DOI: https://doi.org/10.5720/kjcn.2024.00014
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Abstract
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ePub - Objectives
This study aimed to explore the cross-sectional association between health-related quality of life (HRQoL) according to the number of comorbidities in older adults with type 2 diabetes mellitus (T2DM) using the Euro Quality of Life-5 Dimensions (EQ-5D) index. Methods: This study included 3,553 participants aged ≥ 65 years from the 2008–2020 Korea National Health and Nutrition Examination Survey. Dietary data were collected through 24-hour recall interviews by trained researchers, and demographic and lifestyle information via self-administered questionnaires. HRQoL was measured using a modified EQ-5D scale. Multivariable linear regression analyzed the associations between EQ-5D scores, nutrients and comorbidity, controlling for sociodemographic and health variables. Results: Most participants reported ‘no problems’ in the EQ-5D scores, although approximately 17% to 47% of participants reported ‘some problems’ or ‘extreme problems,’ depending on the dimension. As comorbidities increased, significant declines were observed across all dimensions, particularly in mobility, usual activities, pain/discomfort, and anxiety/ depression. Nutrient intake analysis revealed that participants with three or more comorbidities consumed less carbohydrates, but more fat. Conclusion: Our findings demonstrate that among older adults with T2DM, a higher number of comorbidities is associated with decreased HRQoL. Additionally, there are differences in nutrient intake patterns among those with more comorbidities, specifically decreased carbohydrate intake and increased fat intake. These results emphasize the need for comprehensive and tailored management strategies that consider both diabetes and the co-occurring health conditions. By addressing the complex healthcare needs of individuals with multiple comorbidities, it is possible to enhance their HRQoL and overall well-being.
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- [English]
- Sex differences in health-related quality of life among older Korean adults with type 2 diabetes mellitus: a cross-sectional study
- Hyeonji Jeong, Kyong Park
- Korean J Community Nutr 2024;29(4):336-347. Published online August 31, 2024
- DOI: https://doi.org/10.5720/kjcn.2024.00003
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Abstract
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- Objectives
This cross-sectional study examined sex differences in Health-Related Quality of Life (HRQoL) among seniors with Type 2 Diabetes Mellitus (T2DM).
Methods
Data from the Korea National Health and Nutrition Examination Survey (2008–2020) were analyzed. The EuroQol-5 Dimensions (EQ-5D), a measure of HRQoL, was used. It comprises five dimensions: mobility, self-care, usual activity, pain/discomfort, and anxiety/depression, each with three levels.
Results
Analysis of 3,826 older adults with T2DM showed a significant increasing trend in the EQ-5D Index from the 4th survey phase onwards (P for trend < 0.001 for both men and women). Men consistently reported higher EQ-5D levels than women across all survey years. Women’s EQ-5D levels remained lower than men’s, maintaining a decade-old disparity (P < 0.05). Men scored significantly higher (P < 0.05) in most EQ-5D domains, except for self-care and anxiety/depression, resulting in a higher total EQ-5D Index (P = 0.001). Increased comorbidities were strongly associated with lower EQ-5D levels in both sexes. Additionally, there was a negative correlation between the EQ-5D Index and refined grain intake for both sexes (P for trend < 0.001), with high-EQ-5D groups consuming fewer refined grains. Women in the high-EQ-5D group consumed more nuts, vegetables, and meat compared to men (P for trend < 0.05).
Conclusions
Our study highlights the sex disparities in HRQoL among older adults with T2DM. The findings suggest the need for tailored treatment guidelines aimed at improving the HRQoL of elderly T2DM patients, with a focus on their sex-specific characteristics. Implementing these tailored guidelines could enhance the HRQoL of older women with T2DM and promote more equitable healthcare outcomes. This underscores the importance of considering sex differences to comprehensively improve the well-being of this population.
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Original Articles
- [English]
- Needs for Development of IT-based Nutritional Management Program for Women with Gestational Diabetes Mellitus
- Chan Jung Han, Sun Young Lim, Eunsuk Oh, Yoon Hee Choi, Kun Ho Yoon, Jin Hee Lee
- Korean J Community Nutr 2017;22(3):207-217. Published online June 30, 2017
- DOI: https://doi.org/10.5720/kjcn.2017.22.3.207
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Abstract
PDFPubReader
- OBJECTIVES
The aim of this study was to examine self-management status, nutritional knowledge, barrier factors in dietary management and needs of nutritional management program for women with Gestational Diabetes Mellitus (GDM).
METHODS
A total of 100 women with GDM were recruited from secondary and tertiary hospitals in Seoul. The questionnaire composed of general characteristics, status of self-management, dietary habits, nutrition knowledge, barrier factors in dietary management, needs for nutrition information contents and nutritional management programs. Data were collected by a self-administered questionnaire. All data were statistically analyzed using student's t-test and chi-square test using SAS 9.3.
RESULTS
About 35% of the subjects reported that they practiced medical nutrition and exercise therapy for GDM control. The main sources of nutrition information were ‘internet (50.0%)’ and ‘expert advice (45.0%)’. More than 70% of the subjects experienced nutrition education. The mean score of nutrition knowledge was 7.5 point out of 10, and only about half of the subjects were reported to be correctly aware of some questions such as ‘the cause of ketosis’, ‘the goal of nutrition management for GDM’, ‘the importance of sugar restriction on breakfast’. The major obstructive factors in dietary management were ‘eating more than planned when dining out’, ‘finding the appropriate menu when dining out’. The preferred nutrition information contents in developing management program were ‘nutritional information of food’, ‘recommended food by major nutrients’, ‘the relationship between blood glucose and food’, ‘tips on menu selection at eating out’. The subjects reported that they need management program such as ‘example of menu by calorie prescription’, ‘recommended weight gain guide’, ‘meal recording and dietary assessment’, ‘expert recommendation’, ‘sharing know-how’.
CONCLUSIONS
Based on the results of this study, it is necessary to develop a program that provide personalized information by identifying the individual characteristics of the subjects and expert feedback function through various information and nutrition information contents that can be used in real life. -
Citations
Citations to this article as recorded by
- Chronically ailing or failing chronically: a typology of South African diners living with diabetes
Adam Viljoen, Martinette Kruger
International Journal of Spa and Wellness.2024; 7(2): 109. CrossRef - Machine Learning-Based Prediction of Abdominal Subcutaneous Fat Thickness During Pregnancy
Moon Sook Hwang, Eunjeong Song, Jeonghee Ahn, Seungmi Park
Metabolic Syndrome and Related Disorders.2023; 21(9): 479. CrossRef - Current Status and Effects of Nutrition Education Programs for Diabetic Patients in Korea
Hae Jin Kang
The Journal of Korean Diabetes.2018; 19(2): 106. CrossRef
- Chronically ailing or failing chronically: a typology of South African diners living with diabetes
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- 3 Crossref
- [English]
- Development and Effects' Analysis of Nutrition Education Program for Diabetes Mellitus at Community Health Center: Focused on Individual Daily Energy Requirements and Food Exchange Units
- Ji Yoon Oh, Sook Bae Kim
- Korean J Community Nutr 2010;15(4):485-497. Published online August 31, 2010
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- The purpose of this study was to investigate effects of the developed nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at a community health center. Developed the nutrition education program, four weeks' nutrition education including provided twice individual meal as diet therapy (2 hour/lesson/week, 4 week), was provided to 20 diabetic elderly (12 male, 8 female, 50-75 yrs): 1st lesson "Introduction: management of diabetes mellitus", 2nd lesson "6 Food groups and sources of 6 food groups", 3rd lesson "Individual daily energy requirements and food exchange units", and 4th lesson "Food choice for diabetes mellitus". For effects' analysis of the developed program, we assessed the changes in anthropometric characteristics; biochemical characteristics and nutrient intakes using 24 hr recall method. Effects of the developed nutrition education program were as follows: weight was significantly decreased, blood urea nitrogen (BUN) and glycosylated hemoglobin (HbA1c) were significantly decreased, and distribution of subjects in BUN and HbA1c was significantly changed. In protein : fat : carbohydrate (PFC) ratio, it was significantly changed from 15.98 : 16.30 : 66.69 to 17.51 : 18.94 : 64.10. In evaluation of nutrient intakes by Dietary Reference Intakes for Koreans (KDRI), protein, fiber, fat, vitamin E, niacin, folic acid, calcium and zinc were shown significantly positive changes in distribution of subjects according to intake level. The index of nutrition quality (INQ), nutrition adequacy ratio (NAR) and mean nutrition adequacy ratio (MAR) were significantly increased. In conclusion, the developed 4 weeks' nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at community health center may improve the symptom of diabetes mellitus.
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- [English]
- Evaluation of Nutrition Education for Diabetes Mellitus Management of Older Adults
- Hyun Joo Kang, Eun Mi Shin, Kyung Won Kim
- Korean J Community Nutr 2009;14(6):734-745. Published online December 31, 2009
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Abstract
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- Diabetes mellitus is the prevalent disease among older adults. The purpose of this study was to implement and evaluate the nutrition education program for diabetes mellitus patients aged 60 and over. The one group pretest and posttest design was employed to evaluate the program effectiveness. Nutrition education program for diabetes mellitus patients was carried out at the public healthy center in Guri city. The 38 out of 63 patients completed education program. They received four sessions of group education during four weeks. Nutrition education materials (booklet, leaflet) for older adults were provided to participants. Data about blood glucose, blood pressure, nutrition and diabetes mellitus knowledge, dietary behavior, dietary intake by 24-hour recalls were collected before and after nutrition education to evaluate the program effectiveness. All data were statistically analyzed using SAS package (ver.8.2) and significant difference was evaluated by chi-square-test, paired t-test and Wilcoxon signed rank test. Study results showed that blood pressure and blood glucose were slightly decreased after nutrition education but they did not reach statistical significance. There were positive changes in nutrition knowledge and dietary behavior. The total score of nutrition and diabetes knowledge increased significantly (p < 0.001), and the total score of dietary behavior was improved (p < 0.05) after nutrition education. Dietary intakes of most of nutrients examined were not significantly different between preand post-test. Based on study results, it appears that nutrition education program for the aged diabetes mellitus patients might effectively increase nutrition knowledge, dietary behavior and diet quality. This nutrition education program can be used at the public health centers or senior centers for the management of diabetes mellitus for older adults.
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- [English]
- Comparison of Nutritional Status and Inflammational Markers in DM and nonDM Hemodialysis Patients
- Suan Kim, Cheongmin Sohn, Dong Wan Chae
- Korean J Community Nutr 2005;10(5):693-699. Published online October 31, 2005
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- Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes (3.45 +/- 0.43 g/dL) than in non-diabetic patients (3.64 +/- 0.36 g/dL) (p < 0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes (1.42 +/- 1.8 mg/dL) (p < 0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r = -0.553, p < 0.01) and non-diabetic (r = -0.579, p < 0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r = 0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) (153.1 +/- 80.1 mg/dL vs 101.6 +/- 62.4 mg/dL) and decreased serum HDL cholesterol (36.89 +/- 13.48mg/dL vs 47.00 +/- 14.02 mg/dL, P < 0.05). There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r = 0.438, p < 0.05) and non-diabetic (r = 0.527, p < 0.05) patients. Serum CRP level was negatively correlated with calorie (r = -0.468, p < 0.05), protein (r = -0.520, p < 0.01) and fat intakes (r = -0.403, p < 0.05) in diabetic patients and calorie (r = -0.534, p < 0.05) and protein intakes (r = -0.559, p < 0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.
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- [English]
- A Study on the Sociopsychological Factors Influencing the Dietary Compliance of Diabetics by Using Focus Group Interview
- Sun Jung Choe, Hae Ryun Park, Dong Yean Park, Hong Seok Ahn
- Korean J Community Nutr 2000;5(1):23-35. Published online March 31, 2000
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- The purpose of this study was to find the sociopsychological factors influencing the compliance of dietary regimen in diabetes by using focus group interviews. The data were collected from fifty three diabetes patients in eleven focus groups from September 1997 to March, 1998 in Seoul and Suwon Korea. The interviews were tape-recorded and the contents of the interviews were analysed by researchers. The subjects knew the causes, complications, and therapies of diabetes although they were incorrect at times . Patients had a wide range of outcome expectations from very optimistic to pessimistic. They recognized diabetes as a disease which needs life-time care, and they though that good care could provide a normal life. One the other hand they thought diabetes could lead to death through complications, and cause financial problems as well as social isolation. As for self-efficacy they recognized the importance of compliance to diet regimen but they thought the diet therapy was very difficult and were not very willing to follow it. They felt medical professionals, especially doctors, were influential for the therapies. However they frequently felt counselling provided by doctors was insufficient in time and content and led to attitude problems. They felt support from families and others was often insufficient and inadequate. Nutrition education fostering outcome expectation, social support, and self-efficacy is needed to increased compliance. The most influential referents were medical professional including doctors, nurses, dieticians, so their role in diet therapy should by emphasized.
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- [English]
- Distribution and Prevalence Estimation of Cardiovascular Risk Factors through Community Based Health Examination Survey
- Soon Young Lee, Youngok Kim, Kun Sik Han, Hae Kyung Kim, Ju Won Park, Yeon Kyung Lee, Seung Soo Shin
- Korean J Community Nutr 1999;4(4):521-528. Published online December 31, 1999
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- Cardiovascular disease is very prevalent in Korea, and many risk factors, if properly identified are possibly corrected. However, the study results on prevalence and distribution of risk factors may not be reliable while the risk factors of disease are always issued on health promotion projects conducted recently in a community. The subjects of this study were 854 adults who participated in the health and nutrition survey in a community. They were aged between 20 and 69 and sampled representatively. This study intended to estimate the prevalence and the distribution of risk factors of cardiovascular disease such as hypertention, diabetes mellitus, hypercholesterolemia, and obesity. Systolic blood pressure and diastolic blood pressure levels were estimated at 123.9+/-2.2mgHg(men), 117.9+/-1.7mgHg(women), and 80.4+/-1.5mg(men), 74.9+/-1.1mgHg(women), respectively. Glucose level was estimated at 99.1+/-2.3mg/dl in men, and 95.7+/-1.7mg/dl in women. The estimated level of total cholesterol and HDL-cholesterol were 183.4+/-3.8mg/dl(men), 181.7+/-3.1mg/dl(men), and 122.0+/-4.5mg/dl (women), and body mass index was estimated at 24.0+/-0.4kg/m2 in men and 23.9+/-0.4kg/m2 in men and 23.9+/-0.3kg/m2 in women. The prevalence of hypertension was 20.5% for men, and 14.4% for women. The prevalence of diabetes mellitus was estimated to 6.9% for men, and 6.1% for women. The estimated prevalence of hypercholesterolemia was 3.8%(men), 3.9%(women). The rate of obesity was estimated to 28.5%(men), 28.4% (women), respectively. The levels of blood pressure, glucose, and cholesterol were higher in men than in women in almost all the almost ate groups. The prevalence of hypertension for men is about 20%. It was found that the prevalence of diabetes mellitus for males aged between 40 and 59 was rapidly increased. The risk factor with highest prevalence was obesity, and hypertension and diabetes mellitus were the second and third most prevalent.
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