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심강희,황문숙,김선영,이혜미,장지연,이문규 대한당뇨병학회 2014 Diabetes and Metabolism Journal Vol.38 No.3
Background Longer needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well. Methods First, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression. Results The mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI. Conclusion It is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.
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심강희,황문숙,김선영,이혜미,장지연,이문규 대한당뇨병학회 2014 Diabetes and Metabolism Journal Vol.38 No.2
Background: Longer needle and complicated insulin injection technique such as injecting at a 45-degree angle and making skinfolds may decrease patient compliance to insulin injection therapy. In this light, shorter insulin needles have been recently developed. However, it is necessary to ascertain that such shorter needles are appropriate for Korean patients with diabetes as well. Methods: First, the diverse demographic and diabetic features of 156 Korean adults with diabetes were collected by a questionnaire and a device unit of body fat measurement. The skin and subcutaneous fat thicknesses of each subject were measured by Ultrasound device with a 7- to 12-MHz probe. Data were analyzed using analysis of variance and multiple linear regression. Results: The mean skin thickness was 2.29±0.37 mm in the abdomen and 2.00±0.34 mm in the upper arms, and the mean subcutaneous fat thickness was to 10.15±6.54 mm in the abdomen and 5.50±2.68 mm in the upper arms. Our analysis showed that the factors affecting the skin thickness of the abdomen and upper arms were gender and body mass index (BMI), whereas the factors influencing the subcutaneous fat thickness in the abdomen were gender and BMI, and the factors influencing the subcutaneous fat thickness in the upper arms were gender, BMI, and age. Insulin fluids may not appear to be intradermally injected into the abdomen and upper arms at any needle lengths. The risk of intramuscular injection is likely to increase with longer insulin needles and lower BMI. Conclusion: It is recommended to fully inform the patients about the lengths of needles for insulin injections. As for the recommended needle length, the findings of this study indicate that needles as short as 4 mm are sufficient to deliver insulin for Korean patients with diabetes.
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심강희 대한운동학회 2004 대한운동학회 학술대회 자료집 Vol.2004 No.-
당뇨병은 체질 외에 비만, 과식, 운동부족, 스트레스 등 생활습관과 관련된 여러 가지 위험인자의 영향으로 발병하며, 관리를 소홀히 하면 만성합병증으로 진행된다. 따라서 당뇨병은 생활습관의 병 이면서 만성질환이라고 말한다. 당뇨병환자가 급성합병증을 예방하고, 만성합병증의 위험요인을 줄이기 위해서는 지속적인 의학적 치료와 더불어 좋은 생활습관을 유지하는 것이 당뇨병관리의 기본이다. DCCT(Diabetes Control and Complication Trial)연구 및 UKPD(United kingdom Prospective Diabetes Study)연구에 의하면 적절한 당뇨병관리를 통하여 정상혈당 범위 또는 정상혈당에 가깝게 조절하면 당뇨병성 합병증의 발생을 감소시키고, 생존율을 증가시킬 수 있다고 보고하였다. 따라서 당뇨병환자가 당뇨병성 만성합병증을 예방 및 관리하기 위해서는 당뇨병관리의 장기목표를 세운 후 습관형성의 원리에 따라 바람직한 생활습관을 형성하여 유지하는 것이 필요하다.
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자가혈당 측정결과기반 당뇨교육프로그램이 제2형 당뇨병환자의 혈당조절에 미치는 효과
심강희,황문숙 한국간호교육학회 2013 한국간호교육학회지 Vol.19 No.2
Purpose: The aim of the study was to evaluate the effect of self-monitoring of blood glucose (SMBG)-based Diabetes Self-Management Education (DSME) on glycemic control in type 2 diabetes. Methods: This study was designed to compare changes in glycemic control over 12months in SMBG-based DSME group (n=65) versus control group (n=65). Data were obtained from medical records type 2 diabetic patients treated with oral antidiabetic agents and above HbA1c 7.0% from June 2006 to August 2008. All participants completed DSME defined as informational intervention of lifestyle habits and reinforcement of educational Monthly News letter delivered by the diabetes nurse educator. SMBG-based DSME group requested to measure blood glucose 7 times a day for a week and to record their diary and received counseling with a focus on diet and lifestyle during the education. Assessments were conducted baseline, 3, 6 and 12 months. HbA1c was used as an index of glycemic control. Results: 12 months later, the level of HbA1c was reduced by 1.28±1.68% in experimental group and 0.49±1.05% in the control group. We found a significant effect of Time* Group interaction (p=.013). Conclusion:SMBG-based DSME for patients with type 2 diabetes with oral antidiabetic agents was effective in improving glycemic control and maintaining long-term glycemic control. 본 연구는 경구혈당강하제를 복용하는 제2형 당뇨병 환자를 대상으로 자가혈당 측정결과기반 당뇨교육프로그램이 혈당조절에 미치는 효과를 알아보고자 시도되었으며, 연구결과에따른 결론은 다음과 같다. 자가혈당 측정결과기반 당뇨교육프로그램은 두 군 간에는유의한 차이가 없었지만 당화혈색소 변화는 시간이 경과함에따라 유의한 차이가 있는 것으로 나타났으며(p=.013), 실험군의 당화혈색소가 대조군에 비해 더 많이 감소되었다. 이러한점을 고려할 때, 일주일간의 집중적인 자가혈당 측정을 기반으로 지속적인 추구관리를 포함한 당뇨교육 프로그램은 향후효과적인 교육모델로 활용될 수 있을 것이라 사료된다. 이상의 연구결과를 토대로 다음과 같은 제언을 하고자 한다. 첫째, 제 2형 당뇨병환자들에게 자가혈당 측정결과를 기반으로 하는 당뇨교육 프로그램을 임상현장에서 당뇨관리시스템으로 적용해 볼 것을 제언한다. 둘째, 본 연구에서 적용된 중재방법 중 일부인 목표설정-추구관리 프로그램이 혈당조절에유의한 영향을 주는지를 확인해 보는 효과검증 연구를 제언한다.
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