Journal of Korean Academy of Nursing

Research Paper

Triglyceride-glucose parameters as predictors of diabetes mellitus incidence in Korean adults: a secondary analysis of the Korean Genome and Epidemiology Study: Yu Jin Park, Miseon Shin, Hyun Seon Jeon, Eun Hee Yang; Received September 5, 2024 Accepted February 6, 2025 Published online April 1, 2025; DOI: https://doi.org/10.4040/jkan.24108 [Epub ahead of print]

Abstract PDF ePub: Purpose
This study aimed to evaluate the association between triglyceride-glucose (TyG)–related parameters and the incidence of diabetes mellitus in Korean adults. Data were obtained from the Korean Genome and Epidemiology Study (KoGES).
Methods
This secondary analysis examined data from 6,816 adults aged 40–69 years who participated in the KoGES from 2001 to 2020. TyG–related parameters, including the TyG index, TyG–body mass index (TyG–BMI), TyG–waist circumference (TyG–WC), and TyG–waist-to-height ratio (TyG–WHtR), were assessed. Cox proportional hazards models were employed to determine the association between these parameters and the incidence of diabetes mellitus, with adjustments made for demographic, lifestyle, and health-related characteristics.
Results
Higher levels of all TyG–related parameters were significantly associated with an increased risk of developing diabetes mellitus. Specifically, participants in the highest quartile of the TyG index, TyG–BMI, TyG–WC, and TyG–WHtR exhibited significantly higher hazard ratios for diabetes mellitus incidence compared with those in the lowest quartile (p<.001 for all). Notably, the TyG index demonstrated a stronger predictive value for diabetes mellitus than traditional measures such as the homeostatic model assessment of insulin resistance.
Conclusion
TyG–related parameters are robust predictors of diabetes mellitus incidence in Korean adults. These findings support the incorporation of TyG–related measures into clinical settings for the early identification and intervention of high-risk populations. Utilizing these parameters for early diagnosis and preventive strategies may significantly enhance diabetes mellitus management.

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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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Prevalence and Risk Factors for Diabetes Mellitus and Impaired Fasting Glucose of Adults: Hee Seung Kim, You Ja Ro, Nam Cho Kim, Yang Sook Yoo, Jin Sun Young, Jeong Ah Oh; Journal of Korean Academy of Nursing 2000;30(6):1479-1487. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.6.1479

Abstract PDF

This study was conducted to draw out prevalence and the risk factors of diabetes mellitus and impaired fasting glucose for adults,(age 30-69). The subjects were 2096 adults, who had regular health examinations between January and December of 1999 at K Hospital in Seoul. The data was analyzed using chi-square test, unpaired t-test and logistic regression. Diabetes Mellitus and impaired fasting glucose were diagnosed by ADA (American Diabetes Association, 1997) criteria. The results were as follows: 1. Mens' prevalence of Diabetes Mellitus was 7.9% and womens' prevalence of Diabetes Mellitus was 3.8%. Mens' prevalence of impaired fasting glucose was 10.4% and womens' prevalence of impaired fasting glucose was 6.5%. Prevalences of Diabetes Mellitus and impaired fasting glucose increased with age. 2. Prevalence of Diabetes Mellitus and impaired fasting glucose of obese subjects (relative body weight>=162) was higher than that of overweight subjects (110<=relative body weight<=119) in men and women. 3. The diagnoses of Diabetes Mellitus and impaired fasting glucose increased with systolic blood pressure and triglyceride. 4. Significant factors associated with diabetes in the logistic regression best gut model were age, relative body weight, systolic blood pressure, triglyceride in men, and systolic blood pressure in women. In conclusion, as age, weight, systolic blood pressure and triglyceride get higher, Diabetes Mellitus and impaired fasting glucose prevalence also increases, porportionally.

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Journal of Epidemiology.2013; 23(5): 329. CrossRef

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Comparison of blood glucose concentrations from capillaries and veins in SMBG: Jin Hak Kim; Journal of Korean Academy of Nursing 1998;28(1):143-147. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.1998.28.1.143

Abstract PDF

No abstract available.

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A Comparison of the Rates of Hemolysis and Repeated Blood Sampling using Syringe needles versus Vacuum tube needles in the Emergency Department
Young Hee Sung, Moon Sook Hwang, Jee Hyang Lee, Hyung Doo Park, Kwang Hyun Ryu, Myung Sook Cho, Young Hee Yi, S Song
Journal of Korean Academy of Nursing.2012; 42(3): 443. CrossRef

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The Effect of Oral Glucose on Pain Relief in Newborns: Hye Young Ahn, Me Young Jang, Myung Haeng Hur; Journal of Korean Academy of Nursing 2006;36(6):992-1001. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2006.36.6.992

Abstract PDF

Purpose

This study was done to provide data for a nursing intervention to alleviate newborn pain clinically by investigating the effect of oral glucose.

Purpose

Subjects were newborns hospitalized in the nursery. Informed consent was obtained from parents of 60 newborns. A heel stick was carried out for a test on 3 groups; the experimental, placebo, and control group. The Neonatal infant pain scale(NIPS), respiration rate, heart rate, peripheral oxygen partial pressure(SpO₂), and crying duration were measured to assess pain reaction. All neonatal behaviors were recorded on videotape.

Purpose

There were significant differences in pain behavior during stimulus(F=4.195, p=.020), pain behavior immediately after blood-sampling (F=4.114, p=.021), and pain behavior 3 minutes after that (F=3.630, p=.033). However, there were no significant differences in heart rate, respiration rate, peripheral oxygen partial pressure or crying duration after the heel stick among the groups.

Conclusions

Oral administration of glucose before a heel stick caused the reduction of neonatal pain behavior, which means that it has an effect of pain relief.

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Arnica D30 – an alternative for managing procedural pain in full-term neonates
Penka Petleshkova, Maya Krasteva, Iliyana Pacheva, Snezhana Dragusheva, Margarita Ruseva, Valentina Petkova, Kristina Kilova
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Clinical Implications of the Glucose Test Strip Method for Early Detection of Pulmonary Aspiration in Nasogastric Tube- Fed Patients: Hwa Soon Kim; Journal of Korean Academy of Nursing 2004;34(7):1215-1223. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.7.1215

Abstract PDF: Purpose
This study was performed to test the clinical usefulness of the glucose test strip method for early detection of pulmonary aspiration in tube fed patients.
Method
The subjects for the study were 36 patients who were receiving enteral feedings and 39 patients who were not given enteral feedings. For the analysis, the tube fed patients were divided into two groups (clinically significant aspiration and no aspiration) according to criteria.
Result
The mean glucose concentration of tracheal secretions from non enteral fed patients was 26.35mg/dl and were lower than those concentrations found in tube fed patients (32.75mg/dl). The mean glucose concentration of the aspiration group was 45.60mg/dl and the glucose concentration of the non aspiration group was 19.93mg/dl. The difference was statistically significant (t=2.163, p=. 038). More subjects in the no aspiration group (73%) than the aspiration group (56%) had glucose concentrations below 20mg/dl. After deleting the cases that had samples containing blood, glucose concentrations of tracheal aspirates were lower in both groups.
Conclusion
The glucose level of the aspiration group was significantly lower than the no aspiration group and more subjects in the aspiration group had a glucose level higher than 101mg/dl. Therefore, the glucose test of tracheal secretions in tube fed patients could be a desirable test for screening for tracheal aspiration. Especially the patient who is showing repeatedly high glucose levels should not be given feedings until reassessment is completed.

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The Effects of a Diabetic Educational Program for Coping with Problem Situation on Self-efficacy, Self care behaviors, Coping and Glycemic Control in Type 2 Diabetic Patients: Choun Hee Ko, Mee Ock Gu; Journal of Korean Academy of Nursing 2004;34(7):1205-1214. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.7.1205

Abstract PDF

Purpose

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.

Method

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.

Result

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).

Conclusion

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.

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A Comparison on the Degree of Pain according to Methods of Blood Sugar Test between DM Patients and Healthy Group: Ja Yun Choi; Journal of Korean Academy of Nursing 2003;33(7):928-935. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.7.928

Abstract PDF

Purpose

This study attempts to compare the degree of pain when different methods of blood sugar test are used between a DM patient group and a healthy group.

Method

A sample is composed of 56 DM patients and 57 their family who are admitted in a ward of C university hospital in Gwangju. Data were collected from July, 2001 to December, 2001. The blood sugar tests are administered four different ways. The degree of pain is measured twice with a visual analog scale in a week interval.

Result

The differences in the degree of pain according to methods of blood sugar test were not found between the DM patient group and the healthy group in both measures. The only use of a 27G needle method was shown to cause highest level of pain in comparison with the rest of methods in the first measure of the DM patient group and in both the measures of the healthy group.

Conclusion

The study results indicate that the method using lanceter is more recommendable than method of using a 27G needle. Furthermore, the ice therapy and EMLA cream is likely to be more effective on the pain relief in the healthy group than the DM patient group.

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Comparison of Blood Glucose Levels from the Fingertips of Both Patients with and without Diabetes Who are Receiving Dextrose Fluid Therapy
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Effects of a Coaching Program on Comprehensive Lifestyle Modification for Women with Gestational Diabetes Mellitus: Jung Mi Ko, Jong Kyung Lee; J Korean Acad Nurs 2014;44(6):672-681. Published online December 31, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.6.672

Abstract PDF

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Effects of Web-based Health Education on Blood Glucose and Blood Pressure Improvement in Postmenopausal Women with Impaired Fasting Blood Glucose: Jeong-Ah Oh, Hee-Seung Kim, Min-Jeong Park, Hye-Sun Shim; J Korean Acad Nurs 2011;41(5):724-731. Published online October 31, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.5.724

Abstract PDF

Purpose

The purpose of this study was to investigate the effectiveness of an educational intervention that used both cellular phones and the Internet to provide a short messaging service (SMS) relating to blood glucose, blood pressure, and serum lipid levels in postmenopausal women with impaired fasting glucose (IFG).

Methods

Twenty-eight postmenopausal women were assigned to an intervention group and twenty-one postmenopausal women to a control group. The intervention was provided for 12 weeks. Patients in the intervention group were asked to access a web site by using a cellular phone or to use the Internet directly and input their blood glucose and blood pressure levels weekly. Participants were sent the optimal recommendations weekly by both cellular phone and Internet.

Results

The intervention group had a mean decrease in systolic blood pressure (SBP) level of 8.1 mmHg but changes for the control group were not significant. There was a significant mean change in diastolic blood pressure (DBP) level for the intervention group (-7.7 mmHg). The mean change in the control group was not significant.

Conclusion

This educational intervention using the Internet and a SMS by cellular phone improved levels of SBP and DBP in postmenopausal women with IFG.

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Influence of Pre-operative Fasting Time on Blood Glucose in Older Patients: Misuk Hong, Haesang Yoon; J Korean Acad Nurs 2011;41(2):157-164. Published online April 30, 2011; DOI: https://doi.org/10.4040/jkan.2011.41.2.157

Abstract PDF

Purpose

This study was performed to identify changes in blood glucose at preoperative fasting time in surgical patients over 60 yr.

Methods

Data collection was performed from July, 2008 through July, 2009. Participants consisted of 80 nondiabetic surgical patients. Blood glucose was checked from 3 to 5 times. The 5 times were 2-hr fasting on the pre-operative day (T1, n=80), 8 hr (T2, n=80), 10 hr (T3, n=17), 12 hr (T4, n=34) and 14 hr fasting on the day of the operation (T5, n=29).

Results

Of the patients, 27.5% had a blood glucose level of less than 79 mg/dL at T2; 17.6% at T3; 32.4% at T4; and 17.2% at T5. Mean blood glucose levels were 93.8 mg/dL at T1; 88.4 mg/dL at T2; 91.7 mg/dL at T3; 87.4 mg/dL at T4: and 94.1 mg/dL at T5. Blood glucose was the lowest at T2 (p<.001).

Conclusion

As 17.6-32.4% of the patients showed the blood glucose level of less than 79 mg/dL at 8-14 hr pre-operative fasting, the authors recommend that surgical patients >60 yr-of-age be observed for hypoglycemia during pre-operative fasting of more than 10 hr and that surgical patients >60 yr-of-age with risks for hypoglycemia be scheduled for operation within 10 hr preoperative fasting.

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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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The Effects of a Comprehensive Life Style Modification Program on Glycemic Control and Stress Response in Type 2 Diabetes: Ji Soo Yoo, Eun Jung Kim, Suk Jeong Lee; Journal of Korean Academy of Nursing 2006;36(5):751-760. Published online August 31, 2006; DOI: https://doi.org/10.4040/jkan.2006.36.5.751

Abstract PDF

Purpose

This study was to evaluate the effects of a comprehensive life style modification program on glycemic control and stress response in type 2 diabetes.

Method

The participants(n=34) with type 2 diabetes were divided into either a usual care(control) or treatment(experimental) group. The experimental group(n=21) received a program that was based on a comprehensive life style modification protocol at a weekly meeting for 16 weeks. They also participated in individually prescribed exercise and diet along with stress management and self monitoring. The participants were followed for 6 months, during which postprandial glucose, HbA_1C, and stress response inventory were measured.

Result

The experimental group showed a significant lower postprandial glucose and stress response compared to those of the control group. However, there was no significant change in the HbA_1C value in either group.

Conclusions

These results suggest that a type 2 diabetes comprehensive lifestyle modification program may lead to clinical improvement in glycemic control and reduce the stress response.

Citations

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