Effects of an Intensive Management Program for Diabetic Patients on a Blood Biochemical Profile and Diabetes Knowledge

Su-Jeong Yeo; Bok-Hee Kim

doi:10.5720/kjcn.2018.23.2.148

Journal List > Korean J Community Nutr > v.23(2) > 1109284

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Yeo and Kim: Effects of an Intensive Management Program for Diabetic Patients on a Blood Biochemical Profile and Diabetes Knowledge

Research Article

Korean Journal of Community Nutrition 2018; 23(2): 148-161.

Published online: 30 April 2018

DOI: https://doi.org/10.5720/kjcn.2018.23.2.148

Effects of an Intensive Management Program for Diabetic Patients on a Blood Biochemical Profile and Diabetes Knowledge

Su-Jeong Yeo¹, Bok-Hee Kim²

¹Department of Nutrition Services, Chosun University Hospital, Gwangju, Korea.

²Department of Food & Nutrition, Chosun University, Gwangju, Korea.

Corresponding author: Bok-Hee Kim. Department of Food and Nutrition, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Korea. Tel: (062) 230-7721, Fax: (062) 225-7726, kimbh@chosun.ac.kr

Received 13 February 2018 Revised 14 March 2018 Accepted 26 March 2018

The Korean Society of Community Nutrition

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study examined the effects of nutrition education and exercise therapies on the hematological status and diabetes knowledge of diabetic patients. For this purpose, a 12-week intensive management program was provided to diabetic patients participating in an exercise program in S health subcenter in Kwangju city and the effects were analyzed.

Methods

The subjects were 26 diabetic patients, who provided written informed consent. As a preliminary survey, this study examined the general characteristics, physical status, obesity, blood pressure, hematological status, daily activity level, diabetes knowledge, diet performance, and barriers to diet therapy. After the 12-week intensive management program was completed, a post-test was conducted in the same way as the preliminary test. The data were analyzed with using SPSS 18.0. The data from this study are presented as the mean ± standard deviation. A paired t-test was conducted to compare differences in the means before and after the program. Statistical significance was set to p<0.05.

Results

The results of the program are presented as follows. The HDL-cholesterol levels changed from 39.8 ± 10.5 mg/dL to 48.3 ± 13.1 mg/dL, showing a significant increase (p<0.001). The blood sugar 2 hours after a meal changed from 175.2 ± 67.1 mg/dL to 140.5 ± 42.5 mg/dL, showing a significant decrease (p=0.014). The glycosylated hemoglobin levels decreased significantly from 6.7 ± 1.1% to 6.3 ± 1.0% (p=0.010). The total scores of the daily activity levels increased significantly from 3.8 ± 2.4 to 4.8 ± 2.5 (p=0.040). The scores of knowledge on diabetes increased from 11.5 ± 3.6 to 14.0 ± 3.8 (p=0.001). The scores of knowledge on diet therapy changed from 6.7 ± 2.2 to 7.9 ± 1.7, showing a significant increase (p=0.027).

Conclusions

The 12-week intensive management program intervened by nutrition education and exercise therapies induced positive changes to the HDL-cholesterol, blood sugar 2 hours after a meal, glycosylated hemoglobin, daily activity levels, and knowledge on diabetes.

Keywords: nutrition education and exercise therapy, diabetic patients, blood biochemical profile, diabetes knowledge

Figures and Tables

Table 1

Contents of intensive management program

Table 2

General characteristics of subjects

1) N (%)

Table 3

Changes in anthropometric characteristics by intensive management program

†: Tested by paired t-test

1) Mean ± SD

Table 4

Changes in blood pressure and biochemical characteristics by intensive management program

†: Tested by paired t-test

1) Mean ± SD

2) Sample size: 18

Table 5

Effect of intensive management program on daily activity

†: Tested by paired t-test

1) Mean ± SD

2) Total(Maximum) score was 8 score

Table 6

Effect of intensive management program on knowledge of diabetes and diet therapy

†: Tested by paired t-test

1) Mean ± SD

Table 7

Effect of intensive management program on meal behavior

†: Tested by paired t-test

1) Mean ± SD

Table 8

Effect of intensive management program on barriers of meals

†: Tested by paired t-test

1) Mean ± SD

References

1. Cho KO. A comparative study assessing metabolic profile and diet quality in college women according to their mother's diabetes mellitus. J Korean Diet Assoc. 2009; 15(1):1–9.

2. Park YS, Lee JW, Seo JS, Lee BK, Lee SH. Nutrition education and counseling. 3th ed. Paju: Kyomunsa;2011. p. 4–374.

3. International Diabetes Federation. IDF Diabetes Atlas Eighth Edition 2017 [internet]. 2017. Available from: http://www.diabetesatlas.org/across-the-globe.html.

4. Korean Diabetes Association. Diabetes fact sheet. Seoul: Korean Diabetes Association;2016.

5. Health Insurance Review & Assessment Service, National Health Insurance Service. 2016 National Health Insurance Statistical Yearbook 2017 [internet]. 2017. cited 2017 October 17. Available from: http://www.hira.or.kr/bbsDummy.do?pgmid=HIRAA020045010000&brdScnBltNo=4&brdBltNo=2293&pageIndex=1#none.

6. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001; 344(18):1343–1350.

7. Boule NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trial. JAMA. 2001; 286(10):1218–1227.

8. Song MS, Song KH, Ko SH, Ahn YB, Kim JS, Shin JH. The long-term effect of a structured diabetes program for uncontrolled type 2 diabetes mellitus patients - a 4-year follow-up. J Korean Diabetes Assoc. 2005; 29(2):140–150.

9. Lee JY, Kim CB. Direction of community health promotion in Korea. Korean J Health Promot. 2000; 2(1):3–12.

10. Kim SY, Kim SB. Effects of nutrition education at a community health center on overweight and obese middle-aged women in Jeonbuk area: Focused on personalized daily energy requirement and food exchange units. Korean J Community Nutr. 2017; 22(4):307–322.

11. Kim MJ, Kwon SJ, Lee SY. Effects of low glycemic index nutrition education on the blood glucose control in patients with type 2 diabetes mellitus. Korean J Nutr. 2010; 43(1):46–56.

12. Kang HJ, Sin EM, Kim KW. Evaluation of nutrition education for diabetes mellitus management of older adults. Korean J Community Nutr. 2009; 14(6):734–745.

13. Kim TY, Um SH, Kim WY, Chang NS. Group lunch visits are public health center improve glycemic control in older adults with type 2 diabetes mellitus. Korean J Nutr. 2004; 37(4):302–309.

14. Oh JY, Kim SB. 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. Korean J Community Nutr. 2010; 15(4):485–497.

15. Lee YA, Kim KN, Chang NS. The effect of nutrition education on weight control and diet quality in middle-aged women. Korean J Nutr. 2008; 41(1):54–64.

16. Yim KS, Min YH, Lee TY. Evaluation of effect on nutrition counseling and nutrition education program at a public health center. J Korean Diet Assoc. 1997; 3(2):192–210.

17. Meloche J. Cooking with class: participation soars with hands-on learning and take-aways. J Nutr Educ Behav. 2003; 35(2):107–108.

18. Korean Diabetes Association. 2015 Treatment guideline for diabetes. Seoul: Korean Diabetes Association;2015. p. 2–147.

19. Kim TY, Um SH, Kim WH, Chang NS. Group lunch visits at the public health center improve glycemic control in older adults with type 2 diabetes mellitus. Korean J Nutr. 2004; 37(4):302–309.

20. An SY. Effect of intensive health management program on knowledge, self-care behaviors and glycemic control in diabetic patients [master's thesis]. Chungju National University;2011.

21. Norris SL, Lau J, Smith SJ, Schmid CH, Engelgau MM. Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care. 2002; 25(7):1159–1171.

22. Korean Diabetes Association. Glycosiatrics. 3th ed. Seoul: Golyeouihag;2005. p. 189–190.

23. Kim TY. Group lunch visits at the public health center improve glycemic control in older adults with type 2 diabetes mellitus [master's thesis]. Ewha Womans University;2003.

24. Shim WS, Hong SB, Choi YS, Choi YJ, Ahn SH, Min KY. Development of two parallel diabetes knowledge tests. J Korean Diabetes Assoc. 2006; 30(6):476–486.

25. Korean Diabetes Association. Diabetes diet selection screening (beginner) [internet]. Korean Diabetes Association;2014. cited 2014 April 18. Available from: http://www.diabetes.or.kr/pro/news/index.php?code=board&mode=view&number=1040.

26. Kwon YW. Development and validation of an evaluation instrument to measure diabetic patients' compliance with diet therapy [master's thesis]. Seoul National University;2009.

27. Park Y, Park HH, Ryu SY. Factors associated with active participation in health promotion programs at a public health center. J Agric Med Community Health. 2010; 35(3):287–300.

28. Son SM, Kim HJ. Effect of 12-week low calorie diet and behavior modification on the anthropomeric indices and biochemical nutritional status of obese women. Korean J Community Nutr. 2005; 10(4):525–535.

29. Shin EY, Kim CH, Yoo WS, Kim HG, Kim CY. The effect of case management program for diabetic patients in Korean community. J Korean Community Nurs. 2003; 14(4):559–567.

30. Koproski J, Pretto Z, Poretsky L. Effect of an intervention by a diabetes team in hospitalized patients with diabetes. Diabetes Care. 1997; 20(10):1553–1555.

31. Engelgau MM, Thompson TJ, Herman WH, Boyle JP, Aubert RE, Kenny SJ. Comparison of fasting and 2-hour glucose and HbA1c levels for diagnosing diabetes: diagnostic criteria and performance revisited. Diabetes Care. 1997; 20(5):785–791.

32. Lowe LP, Liu K, Greenland P, Metzger BE, Dyer AR, Stamler J. Diabetes, asymptomatic hyperglycemia, and 22-year mortality in black and white men: the Chicago Heart Association Detection Project in Industry Study. Diabetes Care. 1997; 20(2):163–169.

33. Hanefeld M, Fischer S, Julius U, Schulze J, Schwanebeck U, Schnechel H. Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Intervention Study, 11-year follow-up. Diabetologia. 1996; 39(12):1577–1583.

34. Kim JH, Chang SA. Effect of diabetes education program on glycemic control and self management for patients with type 2 diabetes mellitus. Korean Diabetes J. 2009; 33(6):518–525.

35. Koev DJ, Tankova TI, Kozlovski PG. Effect of structured group education on glycemic control and hypoglycemia in insulin-treated patient. Diabetes Care. 2003; 26(1):251.

36. Moon SJ, Shon CY, Kim JH, Kim HS, Lim HS, Lee HC. Measurement of nutrition counseling effects for diabetes mellitus patients. Korean J Nutr. 1994; 27(10):1070–1077.

37. Kim MJ, Kwon SJ, Ly SY. Effect of low glycemic index nutrition education on the blood glucose control in patients with type 2 diabetes mellitus. Korean J Nutr. 2010; 43(1):46–56.

38. Lee MR, Song MS. Long term effects of a self-care education program promoting self-efficacy for elderly people with diabetes. J Korean Gerontol Nurs. 2003; 5(1):91–101.

39. Howe CJ, Jaward AF, Tuttle AK, Moser JT, Peris C, Buzby M. Education and telephone case management for children with type 1 diabetes: a randomized controlled trial. J Pediatr Nurs. 2005; 20(2):83–95.

40. Kang HJ, Shin EM, Kim KW. Evaluation of nutrition education for diabetes mellitus management of older adults. Korean J Community Nutr. 2009; 14(6):734–745.

41. Yang SO, Ahn SY, Yim ES, Kwon MS. The effects of customized home visiting health service in Gangwon-do: Focused on hypertension and DM clients. J Korean Acad Community Health Nurs. 2008; 19(1):88–100.

42. Seo HJ, Jung MS, Park GH. Diabetic knowledge, perceived stress, response patterns of health locus of control and sick-role behavior compliance in diabetic patients. J Kyungpook Nurs Sci. 2003; 7(2):1–18.

43. Kim YS, Seung JJ, Kim DM, Kim SB, Yoo HJ. A study on the evaluation of diet-education program of diabetes. Diabetes Metab J. 1986; 10(2):191–195.

44. Olson JC, Sims LS. Assessing nutrition knowledge from an information processing perspective. J Nutr Educ. 1980; 12(3):157–161.

45. Korean Diabetes Association. Diabetes fact sheet. Seoul: Korean Diabetes Association;2013.

46. McCulloch DK, Mitchell RD, Ambler J, Tattersall RB. Influence of imaginative teaching of diet on compliance and metabolic in insulin dependent diabetes. Br Med J. 1983; 287(6408):1858–1861.

TOOLS

ORCID iDs: Bok-Hee Kim
https://orcid.org/0000-0002-9762-0948
Similar articles