Journal of Korean Academy of Nursing

Original Articles

Glucose Tolerance and Insulin Secretion patterns by Body Mass Index(BMI) in Offspring of Parents with Non-Insulin Dependent Diabetes Mellitus: Young Im Moon, Hye Ja Park, Young Ae Chang; Journal of Nurses Academic Society 1997;27(3):694-704. Published online March 30, 2017; DOI: https://doi.org/10.4040/jnas.1997.27.3.694

Abstract PDF: This study was designed to assess the body fat distribution, and also to investigate the effects of body fat on glucose tolerance and on insulin secretion pattern by body mass in offspring of parents with NIDDM. The subjects consisted of twenty parents with NIDDM who had been admitted to the Department of Internal Medicine or had been seen in the outpatient clinic at Kangnam St. Mary's Hospital, Catholic University between February to March, 1995. Twenty offspring were randomly selected from forty six offspring of twenty healthy people without a family history of diabetes mellitus were matched by sex, age and body mass index(BMI). The results are as follows : 1. mean fasting serum glucose and insulin levels and insulin/glucose ratio were significantly greater in offspring than in the control subjects with BMI>or=25kg/m2 in the offspring and in the BMI<25kg/m2(P<0.05). 2. The total glucose area and insulin area were significantly greater in both the offsping and the control subjects with BMI>or=25kg/m2 than in both the offspring and the control subjects with BMI<25kg/m2(P<0.05). 3. Upper body skinfold thickness, Waist hip ratio(WHR), serum levels of total cholesterol and triglyceride(TG), total dietary calorie intake and protein intake in both the offspring and the control subjects with BMI>or=25kg/m2 were greater than those with BMI<25kg/m2(P<0.05). On the other hand, HDL-cholesterol in both the offspring and the control subjects with BMI 25kg/m2 was lower than those with BMI<25kg/m2(P<0.05). 4. The major variables influencing the total glucose area were subscapular skinfolds thickness and WHR and the major variables influencing the total insulin area were suprailiac skinfolds thickness, WHR, TG and free fatty acid. In the light of the results, glucose intolerance and insulin resistance were affected by body mass index, Upper body fat, WHR, and lipids(TG, Free fatty acid), it is implied that these are influencing factors on total glucose area and total insulin area. The identification of these factors might provide a useful tool to identify individuals at high risk of diabetes mellitus. Therefore, various nursing intervention programs to reduce obesity could be given to both the offspring of parents with NIDDM and to the obese healthy controls before diabetes mellitus develops.

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The Effects of Exercise Therapy Applied in an Efficacy Expectation Promoting Program on Self-Efficacy and Metabolism: in NIDDM(Non-Insulin Dependent Diabetes Mellitus) Patients: Chun Ja Kim; Journal of Korean Academy of Nursing 1998;28(1):132-142. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.1.132

This study was conducted to investigate whether exercise therapy applied in an efficacy expectation promoting program based on the self-efficacy theory of Bandura(1977) would increase self-efficacy and metabolism in NIDDM patients. The study design was a nonequivalent control group pre-test post-test quasi-experimental design. The exercise therapy applied in the efficacy expectation promoting program was composed of a staged exercise program, a small booklet relating personal experience with diabetes mellitus and a telephone coaching program on performance accomplishment, vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. The subjects of the study were twenty eight NIDDM patients who received follow-up care regularly through the out-patient department of endocrine medicine in one general hospital which had a diabetic clinic. Fourteen were assigned to the experimental group and fourteen to the control group. The experimental group participated in the exercise therapy applied in the efficacy expectation promoting program from three to five times per week for four weeks and the control group did not have the program. The collected data were analyzed using the x2-test, t-test, paired t-test, and Cronbach's Alpha using SPSS/PC+. The results are summarized as follows : 1. Experimental group had higher efficacy score than control group(t=5.98, p=.00). And, There was a significant different in the efficacy score before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(t=-6.42, p=.00). 2. Experimental group did not have lower level of glucose metabolism than control group(FBS : t=.32, p=.75, HbA1C : t=.60, p=.55, pc 2hrs. glucose : t=-.29, p=.78). But, There was a significant different in the amount of glucose metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(FBS : t=3.63, p=.003, HbA1C : t=4.20, p=.00 2hrs . glucose : t=1.93, p=.001). 3. Levels of lipid metabolism were partly a significant different between Experimental group and control group(triglyceride : t=-1.87, p=.07, HDL cholesterol : t=-.29, p=.77, body weight : t=1.78, p=.09, Total cholesterol : t=-2.17, p=.04). And, There was partly a significant different in the amount of lipid metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(triglyceride : t=2.50, p=.03, HDL cholesterol : t=-.43, p=.67, body weight : t=5.34, p=.00, Total cholesterol : t=2.26, p=.04). In conclusion, it was found that exercise therapy applied in an efficacy expectation promoting program was an effective nursing intervention for increasing self-efficacy and metabolism.

Citations

Citations to this article as recorded by

Effects of a community‐based intervention on cardio‐metabolic risk and self‐care behaviour in older adults with metabolic syndrome
Chun‐Ja Kim, Jee‐Won Park, Hyung‐Ran Park
International Journal of Nursing Practice.2014; 20(2): 212. CrossRef
Utility of a Web-based Intervention for Individuals With Type 2 Diabetes
CHUN-JA KIM, DUCK-HEE KANG
CIN: Computers, Informatics, Nursing.2006; 24(6): 337. CrossRef
The impact of a stage-matched intervention to promote exercise behavior in participants with type 2 diabetes
Chun-Ja Kim, Ae-Ran Hwang, Ji-Soo Yoo
International Journal of Nursing Studies.2004; 41(8): 833. CrossRef

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Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes: Youngshin Song, Younghee Jeon, Jeonghwa Cho, Bohyun Kim; J Korean Acad Nurs 2016;46(6):813-823. Published online December 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.6.813

Abstract PDF

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

Citations

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Development and validation of a Chinese insulin medication literacy scale for patients with diabetes mellitus
Fangying Si, Tao Feng, Xiangfen Shi, Sufang Chen
Frontiers in Pharmacology.2025;[Epub] CrossRef
Using Motivational Interviewing to Overcome Psychological Insulin Resistance
Sung-Chul Lim
The Journal of Korean Diabetes.2023; 24(4): 227. CrossRef
Factors Influencing the Subjective Health Status of Men with Insulin-treated Type 2 Diabetes Mellitus: A Secondary Analysis Using Quantile Regression Analysis
Kang Sun Lee, Hyuk Joon Kim, Young Man Kim, Hye Young Kim
Journal of Korean Academy of Fundamentals of Nursing.2023; 30(4): 530. CrossRef
Factors affecting the health status of patients with type 2 diabetes mellitus receiving insulin treatments: A multi‐mediation path analysis
Kang Sun Lee, Hye Young Kim, Heung Young Jin
Journal of Clinical Nursing.2022; 31(9-10): 1285. CrossRef
Psychological Insulin Resistance: Key Factors and Intervention
Yeon Jeong Jang
The Journal of Korean Diabetes.2021; 22(3): 192. CrossRef
Diyabetli Hastalarda Psikolojik İnsülin Direnci Ölçeğinin Türkçeye Uyarlanması
Kevser IŞIK, Hilal YILDIRIM, Zeliha CENGİZ
Turkish Journal of Family Medicine and Primary Care.2021; 15(4): 726. CrossRef
The role of psychological insulin resistance in diabetes self‐care management
Ancho Lim, Youngshin Song
Nursing Open.2020; 7(3): 887. CrossRef
Psychological Insulin Resistance and Low Self-efficacy as Barriers to Diabetes Self-care Management in Patients with Type 2 Diabetes
Bohyun Kim, Youngshin Song, Jong Im Kim
Korean Journal of Adult Nursing.2019; 31(1): 61. CrossRef
Factors influencing psychological insulin resistance in type 2 diabetes patients
Ji Hyeon Yu, Hye Young Kim, Sung Reul Kim, Eun Ko, Heung Yong Jin
International Journal of Nursing Practice.2019;[Epub] CrossRef
Assessing Psychological Insulin Resistance in Type 2 Diabetes: a Critical Comparison of Measures
E. Holmes-Truscott, F. Pouwer, J. Speight
Current Diabetes Reports.2017;[Epub] CrossRef

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Concept Analysis for Psychological Insulin Resistance in Korean People with Diabetes: Youngshin Song; J Korean Acad Nurs 2016;46(3):443-453. Published online June 30, 2016; DOI: https://doi.org/10.4040/jkan.2016.46.3.443

Abstract PDF

Purpose

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

Methods

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.

Results

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.

Conclusion

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.

Citations

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Development and validation of a distress measurement for insulin injections among patients with diabetes
Eujin Choi, Min-Sun Kim, Juhee Cho, Sooyeon Kim, Eun Kyung Kwon, Youngha Kim, Danbee Kang, Sung Yoon Cho
Scientific Reports.2023;[Epub] CrossRef
The Mediating Effect of Experiential Avoidance on the Relationship between Diabetes Distress and Self-Stigma in People with Diabetes Mellitus Type 2 in Republic of Korea
Kawoun Seo
Healthcare.2023; 11(20): 2773. CrossRef
The Mediating Effect of Acceptance Action in the Relationship between Diabetes Distress and Self-stigma among Old Adults with Diabetes in South Korea
Hyesun Kim, Kawoun Seo
Journal of Korean Academy of Community Health Nursing.2022; 33(4): 446. CrossRef
Psychological Insulin Resistance: Key Factors and Intervention
Yeon Jeong Jang
The Journal of Korean Diabetes.2021; 22(3): 192. CrossRef
The role of psychological insulin resistance in diabetes self‐care management
Ancho Lim, Youngshin Song
Nursing Open.2020; 7(3): 887. CrossRef
Effect of Psychological Insulin Resistance, Diabetes Distress, and Diabetes Self-Efficacy on the Insulin Therapy Adherence of Patients with Type 2 Diabetes: An Analysis Based on the Actor-Partner Interdependence Model
Ji-Soon Kang, Jun-Hee Park, Jeong-Won Han
Korean Journal of Adult Nursing.2020; 32(2): 167. CrossRef
Willingness of people with Type 2 diabetes to start insulin therapy: Evidence from the South African Tshwane Insulin Project (TIP)
Patrick Ngassa Piotie, Paola Wood, Elizabeth M. Webb, Tessa S. Marcus, Paul Rheeder
Diabetes Research and Clinical Practice.2020; 168: 108366. CrossRef
Predictors of glycemic control after decline of insulin therapy by patients with type 2 diabetes
Luisa Florez, Maria Shubina, Alexander Turchin
Journal of Diabetes and its Complications.2019; 33(11): 107418. CrossRef
Psychological Insulin Resistance and Low Self-efficacy as Barriers to Diabetes Self-care Management in Patients with Type 2 Diabetes
Bohyun Kim, Youngshin Song, Jong Im Kim
Korean Journal of Adult Nursing.2019; 31(1): 61. CrossRef
Factors influencing psychological insulin resistance in type 2 diabetes patients
Ji Hyeon Yu, Hye Young Kim, Sung Reul Kim, Eun Ko, Heung Yong Jin
International Journal of Nursing Practice.2019;[Epub] CrossRef
Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes
Youngshin Song, Younghee Jeon, Jeonghwa Cho, Bohyun Kim
Journal of Korean Academy of Nursing.2016; 46(6): 813. CrossRef

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The Effects of Tailored Diabetes Education on Blood Glucose Control and Self-Care: Kyung Sun Hyun, Kwang Mi Kim, Sook Hee Jang; J Korean Acad Nurs 2009;39(5):720-730. Published online October 31, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.5.720

Abstract PDF

Purpose

The purpose of this study was to test the effects of tailored diabetic education on blood glucose control and self-care for patients with type 2 diabetes on insulin therapy.

Methods

The participants were 60 patients (experimental group: 30, control group: 30) with type 2 diabetes on insulin therapy. The patients were being seen at a university hospital in Seoul, Korea. Group diabetic education and tailored diabetic education were given to the experiment group while group diabetic education only was given to the control group. Data were collected before and three months after the education. χ² test, t-test, and ANCOVA were used to analyze the data.

Results

No significant differences in postprandial (PP2hrs) glucose and HbA1c levels were found between the two groups. Participants in the experiment group showed statistically significant differences in the area of self-glucose test, management of insulin injection, and life style change compared to those in the control group.

Conclusion

The results indicate that tailored education for patients with diabetes on insulin therapy improve self-glucose test, management of insulin injection, and life style. Therefore it is suggested that tailored education can be applied in diabetic education to improve self-care.

Citations

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Designing a Self-Care Integrated Protocol and Evaluating its Validity in Type 2 Diabetic Patients; the Case of a Single Subject
Susan Salary, Rasul Roshan, Hamid Pour Sharifi, Hojjatollah Farahani
Health Research Journal.2021; 7(1): 1. CrossRef
Self-Management Nursing Intervention for Controlling Glucose among Diabetes: A Systematic Review and Meta-Analysis
Mi-Kyoung Cho, Mi Young Kim
International Journal of Environmental Research and Public Health.2021; 18(23): 12750. CrossRef
Assessment of type 2 diabetes patients’ self-care status learned based on the national diabetes control and prevention program in health centers of a selected city, Iran
Roghayeh Ershad Sarabi, Zahra Mokhtari, Ahmad Naghibzadeh Tahami, Vahid Reza Borhaninejad, Ali Valinejadi
Koomesh journal.2021; 23(4): 465. CrossRef
The Effects of a Self-care Management Program for Patients with Diabetic Foot Ulcers
Jung Yoon Kim, Eui-Young Cheon
Journal of Korean Biological Nursing Science.2016; 18(2): 78. CrossRef
Group based diabetes self-management education compared to routine treatment, waiting list control or no intervention for people with type 2 diabetes mellitus
Aslak Steinsbekk, Lisbeth Ø. Rygg, Monde Lisulo, Marit By Rise, Atle Fretheim
Cochrane Database of Systematic Reviews.2015;[Epub] CrossRef
Effects of Individual and Group Education Programs on Coping and Self-care Behaviors in Cancer Patients
Young Mi Kim, Won Ock Kim, Sang Sook Han
Journal of East-West Nursing Research.2014; 20(1): 1. CrossRef
Development of a Comprehensive Self-Management Program Promoting Self Efficacy for Type 2 Diabetic Patients
Ju-Young Park, Il-Sun Ko
Journal of Korean Academy of Fundamentals of Nursing.2012; 19(1): 74. CrossRef
Investigation of Effect on Glycosylated Hemoglobin, Blood Pressure, and Body Mass Index of Diabetes Intensive Education Program in Patients With Type 2 Diabetes Mellitus
Emel Beyazıt, Mukadder Mollaoğlu
American Journal of Men's Health.2011; 5(4): 351. CrossRef

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