일개 농촌지역 저소득층 당뇨병환자의 관리 상태
Management of Diabetic Mellitus in Low-income Rural Patients
2
조회
0
다운로드
8
인용
0
참고문헌
키워드
초록
Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7 8.7 years and the duration of diabetes was 8.9 8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.
Abstract
Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7 8.7 years and the duration of diabetes was 8.9 8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.
참고문헌 (37)
- Amos AF, "The rising global burden of diabetes and its complications: Estimates and projections to the year 2010", Diabet Med, 14(5), pp.S1~S85 (1997)
- Prevention of Diabetes Mellitus, "World Health Organization", ~, pp.no. 844 (1994)
- "WHO Diabetes Programme"[URL]
- Park YS, "Prevalence of diabetes and IGT in Younchon country, South-Korea", Diabetes Care, 18(4), pp.545~548 (1995)
- Kim SM, "Prevalence of diabetes and impaired fasting glucose in Korea", Diabetes Care, 29(2), pp.226~231 (2006)
- Kim JS, "Mean fasting blood glucose level and an estimated prevalence of diabetes mellitus among a representative adult Korean population", Korean J Prev Med, 26(3), pp.311~320 (1993)
- Korea Institute for Health and Social Affairs, "The Third Korea National Health and Nutrition Examination Survey (KNHANES ) 2005" (2006)
- Korea Center for Disease Control and Prevention, "In-deep Analyses of the Third National Health and Nutrition Examination Survery: The Health Examination Part", pp.135~ (2007)
- 박석원, "전국표본조사에 의한 우리나라 당뇨병 관리실태: 건강보험자료 분석결과", Diabetes and Metabolism Journal, 31(4), pp.362~367 (2007), 대한당뇨병학회
- 김상아, "우리나라 당뇨병의 유병률과 관리 상태", 대한내과학회지, 68(1), pp.10~17 (2005), 대한내과학회
- Noh JH, "Current status of diabetes management in elderly Koreans with diabetes", Diabetes Res Clin Pract, 77(1), pp.S71~S75 (2007)
- Task Force Team for Constructing Basic Statistics of Diabetes Mellitus in Korea, "Diabetes in Korea 2007: Task Force Team for Constructing Basic Statistics of Diabetes Mellitus in Korea Report", pp.64~ (2007), Hwang Geum Eo Jang Co
- Levey AS, "A simplified equation to predict glomerular filtration rate from serum creatinine", (Abstract) J Am Soc Nephrol, 11, pp.A0828~ (2000)
- Levey AS, "National Kidney Foundation practice guidelines for chronic kidney disease: Evaluation, classification, and stratification", Ann Intern Med, 139(2), pp.137~147 (2003)
- Friedewald WT, "Estimation of the concentration of low-density lipoprotein cholesterol in plasm, without use of the preparative ultracentrifuge", Clin Chem, 18(6), pp.499~502 (1972)
- Chobanian AV, "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report", JAMA, 289(190), pp.2560~2572 (2003)
- Design, methods, and baseline results. Report Number 7. A modification of the Airlie House classification of diabetic retinopathy, "Diabetic retinopathy study", 1~226, pp.Report Number 6 (1981)
- Stoffers HE, "The diagnostic value of the measurement of the ankle-brachial systolic pressure index in primary health care", J Clin Epidemiol, 49(12), pp.1401~1405 (1996)
- "Healthy People 2010/Diabetes. Washington: US Department of Health and Human Service"[URL]
- American Diabetes Association, "Standards of Medical Care in Diabetes-2008", Diabetes Care, 31(1), pp.S12~S54 (2008)
- Deedwania PC, "Hypertension and diabetes:New therapeutic options", Arch Intern Med, 160(11), pp.1585~1594 (2000)
- Statton IM, "Association of glycemia and macrovascular and microvascular complications in type 3diabetes: Prospective observational study", BMJ, 321(7258), pp.405~412 (2000)
- Gaede P, "Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes", N Engl J Med, 348(5), pp.383~393 (2003)
- Mooradian AD, "Dyslipidemia in type 2 diabetes mellitus", Nat Clin Pract Endocrinol Metab, 5(3), pp.150~159 (2009)
- Mattock MB, "Microalbuminuria and coronary heart disease in NIDDM: An incidence study", Diabetes, 47(11), pp.1786~1792 (1998)
- Klausen KP, "Very low level of microalbuminuria is associated with increased risk of death in subjects with cardiovascular or cerebrovascular diseases", J Intern Med, 260(3), pp.231~237 (2006)
- Klausen K, "Very low levels of microalbuminuria are associated with increased risk of coronary heart disease and death independently of renal function, hypertension, and diabetes", Circulation, 110(1), pp.32~35 (2004)
- Christensen PK, "Renal function and structure in albuminuric type 2 diabetic patients without retinopathy", Nephrol Dial Transplant, 16(2), pp.2337~2347 (2001)
- Naidoo DP, "The link between microalbuminuria, endothelial dysfunction and cardiovascular disease in diabetes", Cardiovasc J S Afr, 13(4), pp.194~199 (2002)
- American Diabetes Association, "Peripheral arterial disease in people with diabetes", Diabetes Care, 26(12), pp.3333~3341 (2003)
- Gregg EW, "1999-2000 national health and nutrition examination survey: Prevalence of lower-extremity disease in the US adult population ≥40 years of age with and without diabetes", Diabetes Care, 27(7), pp.1591~1597 (2004)
- 김성권, "The Prevalence of Chronic Kidney Disease (CKD) and the Associated Factors to CKD in Urban Korea: A Population-based Cross-sectional Epidemiologic Study", Journal of Korean Medical Science, 24, pp.S11~S21 (2009), 대한의학회
- 문은준, "제2형 당뇨병환자의 임상적 특징 및 직접의료비용 조사", Diabetes and Metabolism Journal, 32(4), pp.358~365 (2008), 대한당뇨병학회
- Hamdy O, "Diet and exercise in thpe 2 diabetes mellitus", Endocrinol Metab Clin North Am, 30(4), pp.883~907 (2001)
- Eliasson B, "The insulin resistance syndrome in smokers is related to smoking habits", Arterioscler Thromb, 14(12), pp.1946~1950 (1994)
- American Diabetes Association, "Nutrition recommendations and principles for people with diabetes mellitus", Diabetes Care, 23(1), pp.S43~S46 (2000)
- Franz MJ, "Nutritional principles for the management of diabetes and related complications", Diabetes Care, 17(5), pp.490~518 (1994)
