DOI QR코드

DOI QR Code

한국 당뇨병 성인의 혈당조절 장애요인

Barrier Factors Influencing Glycemic Control in Korean Adults with Diabetes

  • Taehui Kim (Dept. of Nursing, Joongbu University) ;
  • Bohyun Kim (Dept. of Nursing, Chungwoon University)
  • 투고 : 2024.01.24
  • 심사 : 2024.02.20
  • 발행 : 2024.02.28

초록

본 연구는 한국 30세 이상 60미만 성인을 대상으로 당화혈색소 6.5% 이상 그룹과 미만 그룹간의 일반적 특성, 신체적 요인, 정신적 요인, 건강문해력 특성 등의 차이를 비교하고, 혈당조절에 영향을 미치는 요인을 성별에 따라 비교하기 위해 시행하였다. 2019년도부터 2021년도까지 국민건강영양조사 원시자료를 이용히여 층화집락추출 및 가중치를 반영하여 복합표본분석 방법을 적용하였다. 한국 30세 이상 60세미만 성인을 대상으로 당화혈색소 6.5% 이상 그룹과 미만 그룹의 인구사회학적 특성, 신체적 요인, 정신적 요인, 건강문해력 등에 따른 차이는 Rao-Scott χ2 test로 분석하였고, 성별에 따른 영향요인을 확인하기 위해 로지스틱 회귀분석 방법으로 분석하였다. 본 연구의 대상자는 438명 이었으며 당화혈색소 6.5% 이상 그룹은 348명으로 나타났다. 당화혈색소 6.5% 미만 그룹과 이상 그룹 간 유의한 차이가 있는 요인은 성별(RCχ2: 7.9, p=.012), 비만(RCχ2: 13.1, p=.006), 당뇨병 유병기간(RCχ2: 9.55, p=.029)이었다. 건강 전문가는 성별, 비만, 당뇨병 유병기간 등이 고혈당 위험성을 높이는 요인임을 파악하고, 혈당 조절 개선을 위한 중재 적용 시 대상자의 신체적 요인, 건강문해력 등을 고려한 건강 증진 전략을 제시할 필요가 있다.

This study compared the health behaviors, health related clinical characteristics between individuals with Glycated Hemoglobin A1C≧6.5% and < 6.5% in 30~59yr. Factors that were associated with A1C were identified by sex, health behaviors, health literacy. This study was an observational study with a cross-sectional design based on data from 2019~2021 Korea National Health and Nutrition Examination Survey. Multiple logistic regression analysis was employed to compute the odds ratios of health behaviors to identify the risk factors for Glycated Hemoglobin. The prevalence of A1C≧6.5% among the total was 79.4%(weighted %, n=348). In the A1C≧6.5%, 71.8% were men. In univariate logistic regression for A1C≧6.5%, sex, duration with diabetes, and body mass index(BMI) were influencing factors. In multiple logistic regression by sex, the factors associated with A1C≧6.5 in women were as follows: education(OR 4.5; 95% CI:1.1, 18.5), duration with diabetes(OR 2.9; 95% CI 1.1, 7.9). Strategies should be targeted to improve health behaviors and clinical characteristics for those in their sex, women in low education level, duration with diabetes. Moreover, healthcare providers should understand the barriers to health behaviors and health literacy to effectively deliver healthcare service.

키워드

참고문헌

  1. Korean Diabetes Association. (2023). Diabetes Fact Sheet in Korea 2022. Korean Diabetes Association(Online). https://www.diabetes.or.kr/bbs/?code=fact_sheet&mode=view&number=2499&page=1&code=fact_sheet
  2. Korean Diabetes Association. (2023). Guideline for Diabetes. Korean Diabetes Association(Online). https://www.diabetes.or.kr/bbs/?code=guide&mode=view&number=1254&page=1&code=guide
  3. H. S. Kim. & S. H. Jeong. (2021). Indefication of Subgroups with Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus: Based on the Korean National and Nutrition Examination Survey from KNHANES VII(2016 to 2018). Journal of Korean Biological Nursing Science , 23 (1), 31-42. DOI : 10.7586/jkbns.2021.23.1.31
  4. S. K. Cho. & K. Park. (2019). Trends in metabolic risk factors among patients with diabetes mellitus according to income levels: the Korea National Health and Nutrition Examination Surveys 1998~2014. Journal of Nutrition and Health, 2288 (3886), 2288-3959. DOI : 10.4163/jnh. 2019.52.2.206
  5. Y. J. Kim. & E. H. Cho. (2019). Lifestyle factors related to glucose control for diabetes management strategeies: Nested case control design using KNHANES data. Journal of the Korea Convergence Society. 10(11). 501-510.
  6. S. W. Oh. & S. B. Kim. (2022). Blood Biochemical Characteristics, Dietary Intake, and Risk Factors Related to Poor HbA1c Control in Elderly Korean Diabetes Patients: Comparison between the 4th(2007-2009) and the 7th (2016-2018) Korea national Health and Nutrition Examination Surveys. Korean Journal of Community Nutrition , 27 (5), 406-421. DOI : 10.5720/kjcn.2022.27.5.406
  7. B. H. Jeon. et. al. (2009). The Relationship of Anxiety Symptoms and Depressive Symptoms to Glycemic Control in Diabetic Patients. Korean journal fo psychosomatic medicine. 16(2). 95-102.
  8. Dahal, P. K., & Hosseinzadeh, H. (2020). Association of health literacy and diabetes self-management: a systematic review. Australian journal of primary health , 25 (6), 526-533. DOI : 10.1071/PY19007
  9. H. J. Lee., B. H. Kim. & Y. S. Song. (2021). Related Factors for Impaired Fasting Glucose in Korean Adults: A Population Based Study. BMC public health, 21 (1), 1-9. DOI : 10.1186/s12889-021-12276-5
  10. Korea Disease Control and Prevention. (2022). The Guideline for Korea National Health and Nutrition Examination Survey. Korea Disease Control and Prevention(Online). https://knhanes.kdca.go.kr/knhanes/sub03/sub03_02_05.do.
  11. The Korean Society of Hypertension. Focused update of the 2018 KSH Guideline . The Korean Society of Hypertension(Online). https://www.koreanhypertension.org/reference/guide?mode=read&idno=10081.
  12. A. Bagust & S. Beale (2003). Deteriorating betacell function in type 2 diabetes: a long-term model. Qjm, 96 (4), 281-288. DOI : 10.1093/qjmed/hcg040
  13. J. E. Aikens. & & J. D. Piette. (2013). Longitudinal association between medication adherence and glycaemic control in type 2 diabetes. Diabetic medicine , 30 (3), 338-344. DOI : 10.1111/dme.12046
  14. H. Y. Kim. & H. S. Kim. (2018). Factors Affecting the Control of HbA1c in Type 2 Diabetic Patient. Journal of Convergence for Information Technology. 8(6). 75-84. DOI : 10.22156/CS4SMB.2018.8.6.075
  15. J. Y. Park. & H. S. Lee. (2019). Obesity as associated factors for Insulin, Fasting blood sugar, and Hemoglobin A1C in Korean adults. Journal of Digital Convergence. 17(10). 349-57. DOI : 10.14400/JDC.2019.17.10.349