- Depression and Self-care Behavior in Patients with Diabetes Mellitus.
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Su Yoen Kim, Jae Ho Lee, Ha Neul Kim, Dong Kyu Kim, Young Na, Guil Sun Kim, Mee Kyoung Kim, Ki Hyun Baek, Moo IL Kang, Kwang Woo Lee, Ki Ho Song
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Korean Diabetes J. 2009;33(5):432-438. Published online October 1, 2009
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DOI: https://doi.org/10.4093/kdj.2009.33.5.432
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Abstract
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- BACKGROUND
Depression is known to be a risk factor for type 2 diabetes mellitus. Conversely, diabetes is also a risk factor for depression, and patients with diabetes have nearly twice the risk of comorbid depression as the general population. Depression in patients with diabetes may cause poor clinical outcomes through lower adherence to self-care activities such as exercise, diet control, and glucose monitoring. Furthermore, diabetic patients with depression are more likely to suffer from microvascular or macrovascular complications. We explored the prevalence of major depressive disorder in Korean diabetic patients and its impact on self-care activities and glucose control. METHODS: We surveyed depressive symptoms and self-care activities in 191 type 2 diabetic patients from the outpatient clinic of the St. Mary's hospital. Two questionnaires were used for assessment, the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS) and the Summary of Diabetes Self-Care Activities (SDSCA). RESULTS: Of the 191 respondents who completed questionnaires, 39 (20.4%) patients were categorized as having major depressive disorder. Among the depressed patients, only six (15.3%) had been previously evaluated and managed for their psychiatric problems. The incidence of depression was significantly higher in female diabetic patients compared to patients without depression (74.4% vs. 45.4%, P<0.001). Patients with depression showed significantly poorer diet control (18.5 vs. 15.9, P = 0.046) and less glucose monitoring (4.1 vs. 2.7, P = 0.047). However, there were no differences in exercise, foot care, or smoking status between the two groups. Additionally, metabolic parameters such as HbA1C and lipid profile were not significantly different between the two groups. CONCLUSION: Many diabetic patients are suffering from depression and exhibit poorer self-care activities than patients without depression. Identifying and managing depressed diabetic patients may help improve their self-care activities.
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Citations
Citations to this article as recorded by
- The Effects of the 2030 Diabetes Camp Program on Depression, Anxiety, and Stress in Diabetic Patients
Jin Hee Jung, Jung Hwa Lee The Journal of Korean Diabetes.2019; 20(3): 194. CrossRef - Association of Resilience and Depression with Self-care Competence in Adult Patients with Diabetes Mellitus
Youngrye Park, Eun Hee Jang, Ji Ok Kim Korean Journal of Adult Nursing.2018; 30(5): 555. CrossRef - Health-Related Quality-of-Life and Diabetes Self-Care Activity in Elderly Patients with Diabetes in Korea
Hacksun Kim, Kisook Kim Journal of Community Health.2017; 42(5): 998. CrossRef - Associations between Smoking, Drinking and Depression among Korean Adults: The 5th Korea National Health and Nutrition Examination Survey
Sun Mi Park, Mi Ah Han, Jong Park, So Yeon Ryu, Seong Woo Choi, Hwan Ho Shin, Mi Hyun Joo Korean Journal of Health Promotion.2016; 16(2): 111. CrossRef - Diabetes and Depressive Symptoms in Korean Women: The Fifth Korean National Health and Nutrition Examination Survey (2010-2011)
Han Na Sung, Hong Seok Chae, Eung Soo Kim, Jong Sung Kim Korean Journal of Family Medicine.2014; 35(3): 127. CrossRef - Effects of Abdominal Circumference, Blood Lipids and Blood Pressure according to Diabetes with VO2peak
Sang-Nam Nam, Jung-Beom Park, Hyoung-Ju Lee The Journal of the Korea Contents Association.2012; 12(12): 363. CrossRef - Effects of a Cardiovascular Risk Reduction Intervention With Psychobehavioral Strategies for Korean Adults With Type 2 Diabetes and Metabolic Syndrome
Chun-Ja Kim, Dae-Jung Kim, Hyung-Ran Park Journal of Cardiovascular Nursing.2011; 26(2): 117. CrossRef
- The Classification of Diabetic Patients Presenting Diabetic Ketoacidosis: The Characteristics of Fulminant Type 1 Diabetes.
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Eun Hee Jang, Jeong Eun Yi, Seung Jae Lee, Sang Hoon Chun, Ki Hyun Baek, Ki Ho Song, Soon Jib Yoo, Jong Min Lee, Kun Ho Yoon, Moo Il Kang, Kwang Woo Lee, Mee Kyung Kim
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Korean Diabetes J. 2008;32(5):428-434. Published online October 1, 2008
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DOI: https://doi.org/10.4093/kdj.2008.32.5.428
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3,028
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- BACKGROUND
The aim of the study was to classify newly diagnosed diabetic patients who initially presented with diabetic ketoacidosis (DKA) into specific types of diabetes and to describe the clinical and biochemical characteristics of patients with fulminant type 1 DM in Korea. METHODS: Using data from 4 hospitals of CMC from 1 January 1999 to 1 March 2008, we identified all patients who manifested DKA when they were first diagnosed as diabetes. Clinical and laboratory data were reviewed from medical records. RESULTS: We identified 51 newly diagnosed diabetic patients manifested DKA. Among them, 14 (27.4%) patients were classified as autoimmune type 1 DM, 8 (15.7%) as antibody negative type 1 DM, 5 (9.8%) as fulminant type 1, 16 (31.4%) as type 2 DM and 8 (15.7%) as secondary DM. Five patients who fulfilled the criteria of fulminant type 1 DM were older (32.2 +/- 10.7 vs. 15.7 +/- 4.4 years, P = 0.010), had shorter duration of symptoms (4.2 +/- 2.7 vs.16.7 +/- 15.2 days, P = 0.014) and lower stimulated C-peptide levels (0.1 +/- 0.0 vs. 0.7 +/- 0.6 ng/mL, P = 0.050) compared with patients with autoimmune type 1 DM. CONCLUSION Newly diagnosed diabetic patients presenting with DKA composed of heterogenous types of diabetes. The prevalence of fulminant type 1 diabetes among them was 9.8% and the clinical and biochemical characteristics of these patients were different from those of autoimmune type 1 DM.
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- A Case of Severe Diabetic Ketoacidosis in a Child with Type 2 Diabetes
Jaesung Yu, Hyunju Jin, Joontae Ko, Hoseok Kang Journal of Korean Society of Pediatric Endocrinology.2011; 16(1): 46. CrossRef - A Case of Fulminant Type 1 Diabetes Mellitus Complicated with Ischemic Ileitis
Se-Won Oh, Ju-Ri Park, Yun-Jeong Lee, Hee-Yeong Kim, Ji-A Seo, Nan-Hee Kim, Kyung-Mook Choi, Sei-Hyun Baik, Dong-Seop Choi, Sin-Gon Kim Journal of Korean Endocrine Society.2009; 24(2): 116. CrossRef
- The Relationship Between the C1818T Polymorphism in Exon 4 of the klotho Gene with Fasting Glucose and Insulin Levels in Korean Women.
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Ki Won Oh, Eun Joo Yun, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Kun Ho Yoon, Moo Il Kang, Seong Gyun Kim, Cheol Young Park, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park
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Korean Diabetes J. 2005;29(3):189-197. Published online May 1, 2005
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Abstract
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- BACKGROUND
A novel gene, termed klotho has been identified as a suppressor of several aging phenotypes, and a genetic defect of klotho in mice resulted in a syndrome resembling human aging, i.e., a short lifespan, infertility, arteriosclerosis, skin atrophy, osteoporosis, and pulmonary emphysema. Since klotho mice also showed an abnormal glucose metabolism, we investigated the relationship between the C1818T polymorphism in exon 4 of the klotho gene and fasting glucose and insulin resistance in Korean women to observe its contribution to glucose metabolism. METHODS: The weight, height, blood pressure, fasting blood glucose, insulin, and lipid profiles were measured in 241 women(mean age, 51.2+/-7.0yr) by using the standard methods. Homeostasis model assessment(HOMA)-insulin resistance(IR), the quantitative insulin sensitivity check index(QUICKI) and HOMAbeta-cell were calculated. The genotyping of the C1818T polymorphism in exon 4 of the klotho gene was performed by allelic discrimination with using a 5' nuclease polymerase chain reaction assay. RESULTS: The allele frequencies were 0.805 for the C allele and 0.195 for the T allele, and they were in Hardy-Weinberg equilibrium(P=0.290). The mean fasting blood glucose(P= 0.005) and HOMA IR(P=0.035) were significantly higher in the T allele carriers compared with the non-carriers. After adjustment was made for age, fasting blood glucose was persistently significant(P=0.015), but the HOMA-IR became marginally significant(P=0.063). In the premenopausal women, the T allele carriers showed a higher mean fasting blood glucose(P=0.038), insulin(P=0.024), HOMA-IR(P=0.010), total cholesterol(P=0.039), and triglyceride levels(P=0.031) than in the non-carriers. After adjustment was made for age, the fasting blood glucose, insulin, HOMA-IR and triglyceride were persistently significant(P= 0.043, P=0.026, P=0.011, P=0.040). Also, the QUICKI, total cholesterol and low-density ilpo-protein cholesterol became marginally significant(P=0.073, P=0.061, P=0.098). For the postmenopausal women, the T allele carriers showed a tendency for higher mean fasting blood glucose levels(P=0.065) and lower HOMA beta-cell levels(P=0.085) than in the noncarriers. These differences became non-significant after adjustment was made for age. CONCLUSION: We observed that the C1818T polymorphism in exon 4 of the klotho gene was partly associated with glucose metabolism in Korean women. Also, these data suggest that the C1818T polymorphism is related with some cardiovascular risk factors in Korean women. The mechanism linking this gene with glucose metabolism warrants further study
- The Association of Interleukin-6 Gene Promoter Region Polymorphism G174C with Insulin Resistance and Metabolic Syndrome in Korean Women.
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Eun Jung Rhee, Won Young Lee, Se Yeon Kim, Eun Sook Oh, Ki Hyun Baek, Ki Won Oh, Moo Il Kang, Sun Woo Kim
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Korean Diabetes J. 2005;29(3):181-188. Published online May 1, 2005
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Abstract
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- BACKGROUND
Interleukin(IL)-6 is a cytokine that is produced from immune cells and adipose tissue. It is thought to be a factor to explain the link between insulin resistance and inflammation, and it is also thought to be involved in glucose metabolism and lipid metabolism. We observed the frequency of the G174C polymorphism in the IL-6 gene promoter region in Korean women and we investigated the association of fasting glucose, insulin resistance indices and metabolic syndrome. METHODS: Measurements of the blood pressure, body fat, fasting glucose, insulin, lipid profiles and anthropometric measurements were done for 268 Korean women(mean age 51.4yrs, range 37~73yrs). Homeostasis model assessement(HOMA) and the quantitative insulin sensitivity check index(QUICKI) were calculated and the presence of metabolic syndrome was assessed according to ATP III criteria. Genotyping was done with the PCRRFLP method on the blood samples of the participants. RESULTS: The allele frequencies were 0.965 for the G allele and 0.035 for the C allele, and they were in Hardy-Weinberg equilibrium(P=0.50). The fasting insulin level and HOMA were significantly higher and the QUICKI was significantly lower in the C allele carriers compared with non-carriers. Although the prevalence of metabolic syndrome was not significantly different according to the different genotypes, among the individual components, the prevalence of hypertriglyceridemia was significantly higher in the C allele carriers compared with the non-carriers. There were no differences in the prevalence of normoglycemia, fasting hyperglycemia and provisional diabetes according to the different genotypes. CONCLUSION: The G174C polymorphism in The IL-6 promoter region was not frequently observed in Korean women. The insulin resistance indices were higher in the C allele carriers compared with the non-carriers. Although the prevalence of metabolic syndrome was not associated with the polymorphism, the prevalence of hypertriglyceridemia was higher in The C allele carriers, suggesting that it is possibile for candidate gene of insulin resistance
- Effects of Cilostazol on Insulin Resistance in OLETF Rats.
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Sung Rae Kim, Ki Hyun Baek, Seung Hyun Ko, Jung Min Lee, Sang Ah Chang, Yoo Bae Ahn, Soon Jib Yoo, Jong Min Lee, Hyun Shik Son, Kun Ho Yoon, Moo Il Kang, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang
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Korean Diabetes J. 2001;25(1):63-70. Published online February 1, 2001
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Abstract
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Insulin resistance is one of the major pathophysiology of type 2 diabetes mellitus. It is reported that cilostazol and cyclic AMP phosphodiesterase inhibitor has the anti-platelet effect as well as an improvement of hypertriglyceridemia in addition to vasodilatation. Furthermore, the previous reports indicated that there is a positive relationship between insulin resistance and dyslipidemia. Thus, we investigated the effects of cilostazol on insulin resistance in OLETF rats using the euglycemic hyperinsulinemic glucose clamp technique, and lipid levels. METHODS: Fifteen five months old OLETF rats were fed for 4 weeks(8 treated with cilostazol and 7 were control), and compare to 20 same aged LETO rats (8 treated with cilostazol and 12 were control) through the glucose infusion rate on euglycemic hyperinsulinemic glucose clamp and lipid profiles. RESULTS: The glucose infusion rate was higher in the cilostazol treated OLETF rats than in the non-cilostazol treated OLETF rats (0.021+/-0.0031 vs 0.027+/-0.0036 mL/min). The levels of free fatty acids (2424.8+/-652.7 vs 1061.8+/-223.2 Eq/L), total cholesterol (145.7+/-17.9 vs 115.4+/-7.6 mg/dL) and triglyceride (146.5+/-46.6 vs 76.1+/-12.5 mg/dL) of cilostazol treated OLETF rats were significantly lower than those of non-cilostazol treated OLETF rats. CONCLUSION: This study result suggest that cilostazol may improve the insulin resistance through the improvement of dyslipidemia in OLETF rats.
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