This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes.

A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0.

Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups.

These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population.

The current study was aimed to investigate the transformational experience of a female student nurse living with type 1 diabetes.

A case study of a 24-year-old diabetes patient was conducted, with interviews concerning the evolving process she had lived through during the period from her later high school years to her graduation from nursing college.

Followings were identified as 5-transformation process: With her diabetes-related limitation, the participant experienced ‘ conflict involving choosing a college and major’. The participant tried to be in charge of managing her diabetes and stepped forward to ‘ adaptation to college life as a new environment’, and she learned more about the process of ‘ evolving awareness of caring’ and developed herself further through the process of ‘ integration of the nurse identity into self-identity’, and finally through the process of ‘ progression and preparation for getting a job’ she achieved her goals, being positive about the future.

The results of the study can provide individuals with diabetes a way of self-management and help the patients and their families in diabetes education. Further research will be needed to refine the results of this study and to learn more about the experiences of patients with type I diabetes in college years.

The purpose of the study was to identify the effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among older adults with DM type II.

Ninety nine DM patients who were older than 50 were recruited from DM clinics or public health centers and conveniently assigned into three groups: the Polar(n=41), counseling(n=30) and control groups (n=28). Participants in both Polar and counseling groups attended weekly problem solving nursing counseling for 12 weeks. Polar heart rate monitors were used in the Polar group to intensify walking exercise. Data was collected from November 2003 to August 2004 and analyzed by ANOVA or ANCOVA using the SPSS WIN program.

After a 12 week intervention, participants in both the Polar and counseling groups reported increased diabetic self care behaviors and decreased blood glucose levels, which is significantly different from those in the control group. There were no distinctively different program effects between the Polar and counseling groups.

Based on the findings, we concluded that problem solving counseling alone could have positive effects on diabetic self care and glycemic controls for older adults with DM. Future research is needed to identify long-term effects of the program.

The purpose of this study was to evaluate the effect of web-based diabetic education on plasma glucose and serum lipids in obese people with diabetes.

A random allocation design with control and experimental groups being assessed pre- and post-intervention was used. Eighteen patients were randomly allocated to an intervention group and 16 to a control group. Participants were requested to input their blood glucose levels weekly for 3 months at http://www.biodang.com by cellular phone or wire Internet. The researcher sentoptimal recommendations to each patient weekly for 3 months using a short message service (SMS) of the cellular phone and wire Internet.

Patients in the intervention group had a mean decrease of 1.2% in glycosylated haemoglobin (HbA₁c) levels and those in the control group had no difference in HbA₁c levels. There was a significant mean change in 2-hour post prandial blood glucose (2HPPG) for the intervention group, with a mean change of -120.1 mg/dl. The mean change in the control group, however, was not significant.

These findings indicate that this web-based intervention using SMS of the cellular phone for 3 months improved HbA₁c and 2HPPG, but did not affect total cholesterol, triglyceride, and high density lipoprotein cholesterol in obese type 2 diabetic patient.

The purpose of this study was to examine the effects of problem solving nursing counseling and walking exerciseon weight loss, cardiovascular risk factors, and self-efficacy of diabetic control among obese diabetic patients. The Polar heart rate monitor was used for walking exercise to utilize the Biofeedback mechanism.

Fifty nine diabetic patients were conveniently placed into experimental (n=35) and control groups (n=24). The experimental group participated inweekly nursing counseling for 12 weeks and was encouraged to do walking exercise using a Polar monitor. The control group remained in the same treatment as before. The data wascollected from November 2003 to August 2004 and analyzed using t-tests and ANCOVAs.

After 12 weeks, the participants in the experimental group reported significantly decreased body weight (p=.004) and total scores on theParma scale (p=.001). While the participants in the control group reported significantly increased levels of blood triglyceride (p=.046) and HDL (p=.018).

Based on the findings, we concluded that problem focused nursing counseling with intensified walking exercise could reduce the risk of cardiovascular complications and body weight among obese diabetic patients. Future research to explore the long-term effects of nursing counseling on diabetic complications is warranted.

The purpose of this study was to explore adult diabetics' eating styles and factors which influence them.

The study adopted an ethnographic method based on a perspective which views the eating style as a cultural phenomenon. Data was collected through a personal interview, participant observation, and documented materials from Oct.2001 to Sept. 2002. In this study, fifteen adult diabetics, with an average age of 57, participated. Data analysis was done by the Spradley's taxonomic analysis technique.

The patients' eating styles were rooted in their viewpoint on illness as well as the meaning of food. Eating styles were classified into 4 types: Pathology-centered, symptom-centered, need-centered, and role-centered.

A conventional approach to the treatment and management of diabetes did not consider the patient's inner world which may play an important role in the successful management of the disease. We found that it was critical for health care personnel to understand patients' values, beliefs and their way of life in order to facilitate the most successful self-care diet.

The purpose of this study was to explore the levels of depression experienced by clients (N=152) with Type 2 Diabetes Mellitus(DM), and to compare the levels of self care activity, metabolic control and cardiovascular risk factors between depressed and non-depressed clients.

Participants aged 50 and above were conveniently recruited in B city. The levels of depression, self-care activity, metabolic control of glucose and lipids, and cardiovascular risk factors of the participants were measured by using questionnaires and blood tests from November, 2003 to June, 2004. Data was analyzed with descriptive statistics, Pearson correlation, Spearman rho and t-test using the SPSS WIN 10.0 program.

The prevalence of depression(CES-D=16) among the participants was 44.1%. The levels of self-care activities(p=.012), glucose(p=.019), total cholesterol(p=.022), LDL(.007) and cardiovascular risk factors(p=.012) were significantly higher in the depressed group than those in the non-depressed group.

Based on the findings, we concluded that many DM patients experience depression and the depression of type 2 DM clients is significantly related with self care activities, diabetic control, and cardiovascular complications. However, this study did not address causality among these variables. Therefore, further research, such as a longitudinal cohort study, is needed to identify causality among these variables.

This study was to evaluate the effects of a short term comprehensive life style modification program on glycemic metabolism, lipid metabolism and body composition in type 2 diabetes mellitus patients.

A nonequivalent control group with a pre post test was designed. Data collection was done from October 2003 to June, 2004 at a hospital. Glycemic metabolism was measured by a.c., p.c. and HbA1c, and lipid metabolism was measured by cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Body Composition was measured by body weight, body mass index, waist, measurement waist per hip ratio, body fat, muscle weight and abdominal fat tissue(intra abdominal distance). The Experimental group, which was composed of 29 participants, was educated based on a life style modification protocol at a weekly meeting for 12 weeks and carried out exercise, diet along individual parameters and self monitoring, while 24 participants in the control group received only diet education.

1.The experimental group showed a significant lower a.c.(t=2.11, p=.04) and HbA₁c(t=2.65, p=.01) compared to those of the control group. 2. The experimental group showed a significant lower LDL than the results of the control group(t=2.42, p=.02). 3. The experimental group showed a significant lower weight(t=3.09, p=.00), BMI(t=3.01, p=.00), body fat(t=2.94, p=.01) and abdominal fat tissue(t=3.05, p=.01) than those of the control group.

The results provided evidence for the effectiveness of a short term comprehensive life style modification program composed of exercise, diet, support, self efficacy elevation and self monitoring in type 2 diabetes mellitus.

This study was conducted to develop and to test the effects of an educational program for coping with problem situations as a nursing intervention in the diabetic patient.

A non-equivalent control group pretest-posttest design was used in this study. Data were collected from January to March, 2002. The subjects of the study consisted of 31 diabetic patients(experimental group : 17 patients, control group : 14 patients). The intervention of an educational program for coping with problem situations was applied to the experimental group for 4weeks(total 8 hours). Data were collected before the educational program, immediately after and 1 months later and were analyzed with repeated measures ANOVA, t-test, and paired t-test.

1. There was a significant difference in self efficacy between the experimental and control groups (F=13.793, p=0.001). 2. There was a significant difference in self care behavior between the experimental and control groups (F=4.583, p=0.041). 3. There was a significant difference in coping behavior of the problem situation between the experimental and control groups (F=62.018, p=0.000). There was a significant difference according to experimental stages(F=4.546, p=0.015) and interaction between education and experimental stages(F=12.039, p=0.000). 4. There was a significant difference in glycemic control between the experimental and control groups (t=-3.112, p=0.004).

These results support that a diabetic educational program for coping with problem situations is effective in promoting and maintaining self efficacy, self care behavior, problem coping behaviors and in improving glycemic control. Thus this program can be recommended as an effective nursing intervention of in-depth education for diabetic patient.

This study was to determine the effect of oral vitamin C supplements on blood sugar and antioxidative status in Types II diabetes mellitus patients.

Data for the study were collected from June 24 to August 31, 2001. Participants(31) took 1g/day vitamin C for 4 weeks, after a 1 - week taking no Vitamin C, followed by Vitamin C 3g/day for 4 weeks. A baseline blood sample was obtained following a 12hour overnight fast and at the end of each 4week Vitamin C administration. Blood samples were taken for plasma vitamin C concentration, fasting blood sugar, HbA1c, superoxide scavenging activity and hydrogen peroxide scavenging activity. The data were analyzed by SPSS for repeated measures ANOVA.

Plasma vitamin C concentration was significantly increased over dose(F=3.316, p=.043). Fasting blood sugar and HbA1c was significantly decreased over dose(F=13.192, p=.000; F=11.995, p=.000). Superoxide scavenging activity and hydrogen peroxide scavenging activity was significantly increased over dose(F=486.138, p=.000; F=177.704, p= .000).

The results suggest that megadose vitamin C supplementation may have a beneficial effect in diabetes mellitus patients on both glycemic control and antioxidant status. Thus dietary measures to increase plasma vitamin C may be an important health strategy for reducing the compliance of diabetic patients.

The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants.

Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants’ DSM behavior and QoL.

The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (γ=.55, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (γ=.15, p=.023), DSM confidence (γ=.25, p<.001), and autonomous motivation (γ=.13, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (γ=.33, p<.001).

The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.

This study was done to develop and validate a measure to evaluate the Korean version of psychological insulin resistance (K-PIR) in patients with diabetes in Korea.

Items were initially generated from literature reviews and interviews with 19 patients with diabetes. The content validity of the items was evaluated by experts. Participants were 424 patients with diabetes recruited through convenience sampling. A cross-sectional survey was designed for item-analysis, exploratory factor analysis with principal axis factoring, and confirmatory factor analysis. Cronbach's alpha was calculated to measure the internal consistency.

For the 24 items of the Korean version of psychological insulin resistance, six items were eliminated because of low correlation with the other items. Exploratory factor analysis with 18-item showed that two factors (psycho-cognitive factor and supportive factor) explained 41.8% of the variance, and the factor structure of K-PIR model had a good fit. Internal consistency of K-PIR with 18 items revealed good reliability.

The findings show that the K-PIR is reliable for measuring the psychological resistance to insulin therapy for Korean patients with diabetes. However, further study is needed to evaluate the validation because the proportion of variation of K-PIR was low in this study.

The purpose of this study was to define the concept for psychological insulin resistance in the Korean population with diabetes.

The Hybrid model was used to perform the concept analysis of psychological insulin resistance. Results from both the theoretical review with 26 studies and a field study including 19 participants with diabetes were included in final process.

The preceding factors of psychological insulin resistance were uncontrolled blood glucose and change in daily life. The concept of psychological insulin resistance was found to have three categories with 8 attributes such as emotional factors (negative feeling), cognitive factors (low awareness and knowledge, low confidence for self-injection) and supportive factors (economic burden, dependency life, embarrassing, feeling about supporters, feeling of trust in, vs mistrust of health care providers). The 8 attributes included 30 indicators.

The psychological insulin resistance of population with diabetes in Korea was defined as a complex phenomenon associated with insulin therapy that can be affected by emotional factors, cognitive factors, and supportive relational factors. Based on the results, a tool for measuring psychological insulin resistance of Koreans with diabetes and effective programs for enhancing insulin adherence should be developed in future studies.

This study was conducted to develop and test the effects of a motivational interviewing self-management program for use with elderly patients with diabetes mellitus.

A non-equivalent control group pretest-posttest design was used. The participants were 42 elderly diabetic patients (experimental group: 21, control group: 21). The motivational interviewing self-management program for elders with diabetes mellitus developed in this study consisted of a 12-week program in total (8 weeks for group motivational interviewing and education and 4 weeks for individual motivational interviewing on the phone). Data were collected between February 13 and May 3, 2013 and were analyzed using t-test, paired t-test, and repeated measure ANOVA with SPSS/WIN 18.0.

For the experimental group, significant improvement was found for self-efficacy, self-care behavior, glycemic control and quality of life (daily life satisfaction, influence of disease) as compared to the control group.

The study findings indicate that the motivational interviewing self-management program is effective and can be recommended as a nursing intervention for elderly patients with diabetes mellitus.

The purpose of the study was to identify factors influencing physical activity among community-dwelling older adults with type 2 diabetes. The study design was based on the Theory of Triadic Influence.

A total of 242 older adults with type 2 diabetes participated in this study. Six variables related to physical activity in older adults, including self-efficacy, social normative belief, attitudes, intention, experience, and level of physical activity, were measured using reliable instruments. Data were analyzed using descriptive statistics, Pearson's correlation analyses, and a path analysis.

The mean physical activity score was 104.2, range from zero to 381.21. The path analysis showed that self-efficacy had the greatest total effect on physical activity. Also, experience had direct and total effects on physical activity as well as mediated the paths of social normative beliefs to attitudes and intention to physical activity. These factors accounted for 10% of the total variance, and the fit indices of the model satisfied the criteria of fitness.

The findings of the study reveal the important role of self-efficacy and past experience in physical activity in older adults with type 2 diabetes.

The objective of this study was to provide a trend analysis of the prevalence of diabetes relative to the socioeconomic, lifestyle, and physiologic risk factors among Korean adults aged over 30 years for a 10-year period using data from the Korean National Health and Nutrition Examination Survey.

Prevalence difference and the slope index of inequality were calculated for each risk factors using binomial regression by considering the repeated cross-sectional features of the data. The prevalence ratio and the relative index of inequality were calculated using log-binomial regression. Linear trend tests were performed using SAS 9.2.

Crude prevalence of diabetes increased over the 10-year period, and was higher for men than for women. It was very high for adults 60 years or over, consistently increasing over time. The prevalence among unemployed men, women with higher level of stress, women with hypertension, and adults with serum triglyceride levels over 135 mg/dL increased over the 10-year period in comparison with the respective control group.

Considering the rapid economic development and associated lifestyle changes in Korea, action should be taken to control the prevalence of diabetes by both preventing and consistently monitoring these identified risk factors using a public-health approach.

The purpose of this study was to investigate the effects of using a Coaching Program on Comprehensive Lifestyle Modification with pregnant women who have gestational diabetes.

The research design for this study was a non-equivalent control group quasi-experimental study. Pregnant women with gestational diabetes were recruited from D women's hospital located in Gyeonggi Province from April to October, 2013. Participants in this study were 34 for the control group and 34 for the experimental group. The experimental group participated in the Coaching Program on Comprehensive Lifestyle Modification. The program consisted of education, small group coaching and telephone coaching over 4weeks. Statistical analysis was performed using the SPSS 21.0 program.

There were significant improvements in self-care behavior, and decreases in depression, fasting blood sugar and HbA1C in the experimental group compared to the control group. However, no significant differences were found between the two groups for knowledge of gestational diabetes mellitus.

The Coaching Program on Comprehensive Lifestyle Modification used in this study was found to be effective in improving self-care behavior and reducing depression, fasting blood sugar and HbA1C, and is recommended for use in clinical practice as an effective nursing intervention for pregnant women with gestational diabetes.

The purpose of the study was to investigate the effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus (GDM).

A non-equivalent control group non-synchronized quasi-experimental design was used. A total of 55 women with GDM were recruited from Cheil General Hospital, Seoul, Korea and were assigned to an experimental (n=28) or control group (n=27). The participants were 24-30 weeks pregnant women who had been diagnosed with GDM as of July 30, 2010. The program was conducted as a 1 hour small group meeting 3 out of 5 times and by telephone-counseling 2 out of 5 times. The integrated self-management program was verified by an expert panel.

Although there was no significant reduction in HbA1c (U= -1.17, p=.238), there were statistically significant increases in self-management (U= -3.80, p<.001) and maternal identity (U= -4.48, p<.001), and decreased 2-h postprandial glucose levels (U= -2.43, p<.015) in the experimental group compared to the control group.

These findings suggest that an integrated self-management program for women with GDM improves self-management, maternal identity, and glycemic control. Further studies are needed to identify the effects of an integrated self-management program on pregnancy and neonatal outcomes.