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Original Articles
Educational Needs Associated with the Level of Complication and Comparative Risk Perceptions in People with Type 2 Diabetes
Youngji Hwang, Dongsuk Lee, Yeon Sook Kim
Osong Public Health Res Perspect. 2020;11(4):170-176.   Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.05
  • 3,242 View
  • 140 Download
AbstractAbstract PDF
Objectives

This study aimed to identify the educational needs of people with type 2 diabetes according to risk perceptions and the level of severity of complications.

Methods

There were 177 study participants who were outpatients of the internal medicine department at a university hospital located in the Republic of Korea, who consented to participate in the survey from December 10, 2016 to February 10, 2017. The data were analyzed using descriptive statistics, Pearson correlation, ANOVA with post-hoc comparison, and multiple regression analysis. Type 2 diabetes complications were classified into 3 groups: no complications, common complications, and severe complications.

Results

There were statistically significant positive correlations between educational needs and comparative risk perceptions, and the level of complication and comparative risk perception. Multiple regression analysis revealed that the factor predicting educational needs of type 2 diabetes people was their comparative risk perceptions, rather than the severity of diabetes complications or sociodemographic variables.

Conclusion

Since risk perception is the factor that indicates the educational needs of people with type 2 diabetes, there is a need to explore factors which increase risk perception, in order to meet educational needs. The findings suggest that a more specific and individualized educational program, which focuses on each person's risk perceptions, should be developed.

The Association Between Lung Function and Type 2 Diabetes in Koreans
Do-Youn Lee, Seung-min Nam
Osong Public Health Res Perspect. 2020;11(1):27-33.   Published online February 28, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.1.05
  • 3,137 View
  • 111 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

This study was performed to test the association between lung function and type 2 diabetes mellitus (T2DM) in Korean patients.

Methods

Data from the 6th Korea National Health and Nutrition Examination Survey (2013 to 2015) was used in this study. There were 3,466 individuals aged between 40 and 80 years, with T2DM, who had a smoking and alcohol status listed, and blood analysis (including blood pressure), were included in this study. Lung function, measured by spirometer ventilatory dysfunction was categorized into 3 patterns: normal, restrictive ventilatory dysfunction, and obstructive ventilatory dysfunction (OVD).

Results

Based on multivariate logistic regression analysis, individuals with restrictive ventilatory dysfunction had an increased odds ratio (OR 1.615, 95% CI 1.137–2.294) for T2DM compared with individuals with normal ventilatory function, whereas OVD had no increase in the odds ratio (OR 1.169, 95 % CI 0.857–1.594). Model 1, which adjusted for age and gender, showed that the probability of having restrictive disorder was 1.559 times (95% CI 1.617–2.082) higher for prediabetes patients, and 2.320 times (95% CI 1.611–3.343) higher for T2DM patients, compared to normal individuals. For Model 4, which was fully adjusted for variables, the probability of having a restrictive disorder was 1.837 times higher for T2DM patients (95% CI 1.260–2.679).

Conclusion

Restrictive ventilatory dysfunction, but not OVD, was associated independently with T2DM.

Obesity, Hypertension, and Type-2 Diabetes Mellitus: The Interrelationships and the Determinants among Adults in Gaza City, Palestine
Mohammed S. Ellulu
Osong Public Health Res Perspect. 2018;9(6):289-298.   Published online December 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.6.02
  • 3,440 View
  • 111 Download
  • 5 Citations
AbstractAbstract PDF
Objectives

To describe the distribution of social factors, lifestyle habits and anthropometric measurements according to hypertension and Type-2 diabetes.

Methods

A cross-sectional study was conducted in Gaza City, Palestine that included 379 patients (20–60 years) who had hypertension and/or diabetes. Three groups of patients were involved; 106 hypertensive (HT), 109 diabetic (T2DM) and 164 hypertensive diabetics (HT + T2DM).

Results

The HT + T2DM group were older and had a higher body mass index compared to HT and T2DM groups. There were 62.3% patients who were female, 49.2% were highly educated HT patients, and 49.3% patients had a low level of education and were HT + T2DM. There were 55.8% patients who lived in large families. Patients who were passive smokers or never smoked before were mostly HT + T2DM, while active smokers and past smokers had T2DM. There were 48.2% patients who were highly physically active who had HT, 40.9% whom were moderately active had T2DM, and 53.8% of patients who had a low level of activity were HT + T2DM. Multivariate linear regression showed that having a diseased mother, living in a large family, being a past or passive smoker, or never having smoked, having a low or moderate level of activity, and having HT or HT + T2DM, were significantly associated with an increased body mass index.

Conclusion

Parental health/disease conditions and environmental factors (social network and lifestyle habits) played the greatest role in the development of obesity and disease.

Public Awareness of Early and Late Complications of Type 2 Diabetes - Application of Latent Profile Analysis in Determining Questionnaire Cut-Off Points
Nasrin Shirmohammadi, Ali Reza Soltanian, Shiva Borzouei
Osong Public Health Res Perspect. 2018;9(5):261-268.   Published online October 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.5.08
  • 3,154 View
  • 115 Download
  • 2 Citations
AbstractAbstract PDF
Objectives

A questionnaire was designed to determine public understanding of early and late complications of Type 2 diabetes mellitus (T2DM).

Methods

A cross-sectional study was performed in participants who were selected using a multi-stage sampling method and a standard questionnaire of 67 questions was proposed. An expert panel selected 53 closed-ended questions for content validity to be included in the questionnaire. The reliability of the questionnaire was tested using Cronbach’s alpha coefficient giving a score of 0.84.

Results

Of the 825 participants, 443 (57.6%) were male, and 322 (41.87%) were 40 years or more. The proportion of low-, moderate- and high- awareness about T2DM and its complications was 29.26%, 62.68%, and 8.06%, respectively. Friends (56.31%) and internet and social networks (20.55%) were the 2 major sources of awareness, respectively. The medical staff (e.g., physicians) had the lowest share in the level of public awareness (3.64%) compared to other sources.

Conclusion

These results present data that shows the general population awareness of T2DM is low. Healthcare policymakers need to be effective at raising awarenes of diabetes and it should be through improved education.

Depression among Korean Adults with Type 2 Diabetes Mellitus: Ansan-Community-Based Epidemiological Study
Chan Young Park, So Young Kim, Jong Won Gil, Min Hee Park, Jong-Hyock Park, Yeonjung Kim
Osong Public Health Res Perspect. 2015;6(4):224-232.   Published online August 31, 2015
DOI: https://doi.org/10.1016/j.phrp.2015.05.004
  • 1,708 View
  • 12 Download
  • 22 Citations
AbstractAbstract PDF
Objectives
There are an increasing number of studies being carried out on depression in patients with diabetes. Individuals with diabetes have been reported as having a higher prevalence of depression compared to those without diabetes. However, only a few studies involving Korean patients have been conducted. The aims of this study were to examine the prevalence of depression and to find various risk factors according to the degree of depression among Korean patients with Type 2 diabetes mellitus (T2DM).
Methods
An Ansan-community-based epidemiological study was conducted from 2005 to 2012. The total number of participants in this study was 3,540, from which patients with diabetes (n = 753) have been selected. The presence of depression was evaluated using the Beck Depression Inventory total score.
Results
The prevalence of depression was 28.8%. The mean age of participants was 55.5 ± 8.2 years. We divided the participants into three groups (without-depression, moderate-depression, and severe-depression groups) to examine the depression prevalence among Korean T2DM patients. The unemployed participants had 2.40 [95% confidence interval (CI) 1.21–4.76], the low-income participants had 2.57 (95% CI 1.52–4.35), the participants using an oral diabetes medicine or insulin had 2.03 (95% CI 1.25–3.32), the participants who are currently smoking had 2.03 (95% CI 1.10–3.73), and those without regular exercise had 1.91 (95% CI 1.17–3.14) times higher odds of depression in the severe-depression group, compared with the without-depression group.
Conclusion
There was a significant association between depression prevalence and diabetes, and we found various risk factors according to the degree of depression in Korean patients with T2DM.
Association of TNF-α 308 G/A Polymorphism With Type 2 Diabetes: A Case–Control Study in the Iranian Kurdish Ethnic Group
Hasan Golshani, Karimeh Haghani, Majid Dousti, Salar Bakhtiyari
Osong Public Health Res Perspect. 2015;6(2):94-99.   Published online April 30, 2015
DOI: https://doi.org/10.1016/j.phrp.2015.01.003
  • 1,665 View
  • 19 Download
  • 15 Citations
AbstractAbstract PDF
Objectives
Tumor necrosis factor-α (TNF-α) plays roles in the development of obesity, insulin resistance, and possibility of Type 2 diabetes mellitus (T2DM). The objective of the current study was to evaluate the association of TNF-α promoter−308 G/A polymorphism with T2DM.
Methods
In all, 1038 patients with T2DM and 1023 normoglycemic controls were included in this study. All participants were genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. Genotypic and allelic frequencies were then analyzed in each group. Serum lipids, fasting glucose, fasting serum insulin, homeostatic model assessment of insulin resistance, and hemoglogin A1c levels were determined by conventional methods.
Results
The allelic frequency of the A allele was significantly different between case and control participants (p = 0.006). Genotypes GA and AA were found to be significantly associated with 2.24- and 3.18-fold increased risk for T2DM, respectively. Similarly, the dominant model of -308 G/A polymorphism was found to have a higher risk for T2DM (odds ratio = 2.34, p = 0.001). Individuals with T2DM carrying the GA + AA genotypes of -308 G/A variation had significantly lower fasting plasma insulin than those carrying GG genotype.
Conclusion
Our findings revealed that there is an association between the TNF-α promoter -308 G/A polymorphism and T2DM in this population.
Development of a Predictive Model for Type 2 Diabetes Mellitus Using Genetic and Clinical Data
Juyoung Lee, Bhumsuk Keam, Eun Jung Jang, Mi Sun Park, Ji Young Lee, Dan Bi Kim, Chang-Hoon Lee, Tak Kim, Bermseok Oh, Heon Jin Park, Kyu-Bum Kwack, Chaeshin Chu, Hyung-Lae Kim
Osong Public Health Res Perspect. 2011;2(2):75-82.   Published online June 30, 2011
DOI: https://doi.org/10.1016/j.phrp.2011.07.005
  • 1,723 View
  • 13 Download
  • 11 Citations
AbstractAbstract PDFSupplementary Material
Objectives
Recent genetic association studies have provided convincing evidence that several novel loci and single nucleotide polymorphisms (SNPs) are associated with the risk of developing type 2 diabetes mellitus (T2DM). The aims of this study were: 1) to develop a predictive model of T2DM using genetic and clinical data; and 2) to compare misclassification rates of different models.
Methods
We selected 212 individuals with newly diagnosed T2DM and 472 controls aged in their 60s from the Korean Genome and Epidemiology Study. A total of 499 known SNPs from 87 T2DM-related genes were genotyped using germline DNA. SNPs were analyzed for significant association with T2DM using various classification algorithms including Quest (Quick, Unbiased, Efficient, Statistical tree), Support Vector Machine, C4.5, logistic regression, and K-nearest neighbor.
Results
We tested these models using the complete Korean Genome and Epidemiology Study cohort (n = 10,038) and computed the T2DM misclassification rates for each model. Average misclassification rates ranged at 28.2–52.7%. The misclassification rates for the logistic and machine-learning algorithms were lower than the statistical tree algorithms. Using 1-to-1 matched data, the misclassification rate of the statistical tree QUEST algorithm using body mass index and SNP variables was the lowest, but overall the logistic regression performed best.
Conclusions
The K-nearest neighbor method exhibited more robust results than other algorithms. For clinical and genetic data, our “multistage adjustment” model outperformed other models in yielding lower rates of misclassification. To improve the performance of these models, further studies using warranted, strategies to estimate better classifiers for the quantification of SNPs need to be developed.

PHRP : Osong Public Health and Research Perspectives