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대한당뇨병학회> 당뇨병(JKD)> 시론 : 만성질환과 의학전문직업성

시론 : 만성질환과 의학전문직업성

Opinion : Chronic Diseases and Medical Professionalism

안덕선 ( Ducksun Ahn )
  • : 대한당뇨병학회
  • : 당뇨병(JKD) 22권1호
  • : 연속간행물
  • : 2021년 03월
  • : 1-5(5pages)

DOI


목차

의학전문직업성(Medical Professionalism)
단체적(집단적) 전문직업성과 자율규제
의사자율기구와 사회적 신뢰
이익단체와 면허기구(Trade Union/ Association vs Regulatory Authority)
당뇨병과 전문직업성
전문직업성과 당뇨병학회
REFERENCES

키워드 보기


초록 보기

Attention to medical professionalism has recently increased in S. Korea. The concept of the word ‘professionalism’ can be difficult to translate into Korean. Professionalism for individual doctors is not difficult to explain, but professionalism of organizations or collective dimension of professionalism are difficult to conceptualize in Korean. This might be due to the different trajectory of professional history of S. Korea from western countries. The collective dimension of medical professionalism is artificially divided into three main areas: professional ethics, clinical autonomy, and self-regulation. The concept of self-regulation is unfamiliar not only to Korea, but also to other Confucian countries such as China and Japan, where all regulatory matters are the responsibility of government entities. Medical professional societies do not have the authority to conduct self-regulation. Contemporarily, doctors organizations are classified according to regulatory or trading function. Medical associations usually are categorized as a trade association or trade union, while the medical council is the medical regulatory authority that guides doctors and their practice. However, patient care is a priority regardless of classification. An organization centered on diabetes mellitus could be classified as a doctors’ organization. Its role must be given to guide the best practice, also to prevent the bad practice for the management of diabetes mellitus based on the principle of self-regulation. To achieve this goal as a professional organization, members must be educated to understand the collective dimension of the medical professionalism.

UCI(KEPA)

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  • : 의약학분야  > 내과학
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  • : 2233-7431
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  • : 연속간행물
  • : 2000-2021
  • : 970


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1시론 : 만성질환과 의학전문직업성

저자 : 안덕선 ( Ducksun Ahn )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 1-5 (5 pages)

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초록보기

Attention to medical professionalism has recently increased in S. Korea. The concept of the word 'professionalism' can be difficult to translate into Korean. Professionalism for individual doctors is not difficult to explain, but professionalism of organizations or collective dimension of professionalism are difficult to conceptualize in Korean. This might be due to the different trajectory of professional history of S. Korea from western countries. The collective dimension of medical professionalism is artificially divided into three main areas: professional ethics, clinical autonomy, and self-regulation. The concept of self-regulation is unfamiliar not only to Korea, but also to other Confucian countries such as China and Japan, where all regulatory matters are the responsibility of government entities. Medical professional societies do not have the authority to conduct self-regulation. Contemporarily, doctors organizations are classified according to regulatory or trading function. Medical associations usually are categorized as a trade association or trade union, while the medical council is the medical regulatory authority that guides doctors and their practice. However, patient care is a priority regardless of classification. An organization centered on diabetes mellitus could be classified as a doctors' organization. Its role must be given to guide the best practice, also to prevent the bad practice for the management of diabetes mellitus based on the principle of self-regulation. To achieve this goal as a professional organization, members must be educated to understand the collective dimension of the medical professionalism.

2Statement : 당뇨병과 비타민D

저자 : 홍준화 ( Jun Hwa Hong )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 6-11 (6 pages)

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Renewed interest in vitamin D has occurred recently because it has been linked to diabetes mellitus, cardiovascular disease, autoimmune disease, infection, and cancer. Research studies continue to support vitamin D deficiency as correlated with development of diabetes mellitus and progression of diabetes complications. However, most research is based on observational, epidemiological studies, which are important for generating hypotheses but do not prove causality. Furthermore, there is lack of evidence demonstrating the role of vitamin D supplementation in preventing diabetes from a prediabetic state or improving glycemic control and diabetes complications. The purpose of this article is to summarize the latest information related to diabetes and vitamin D.

3특집 : 당뇨병과 심부전

저자 : 이은정 ( Eun-jung Rhee )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 12-20 (9 pages)

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Heart failure in patients with diabetes has long been considered a consequence of coronary artery disease. However, recent epidemiological evidence from patients with diabetes has shown a significantly increased prevalence of heart failure in patients without significant coronary artery stenosis, suggesting a separate entity involving diabetic complications. Therefore, heart failure in patients with diabetes is now considered as an independent disease entity, 'diabetic heart'. The mechanism of 'diabetic heart' could be coronary artery disease and diabetic cardiomyopathy caused by advanced glycation end products and altered calcium handling, as well as changes to energy metabolism and oxidative stress in the myocardium of patients with diabetes. Recent cardiovascular outcome trials of anti-diabetic medications demonstrated the protective effects of certain drugs against heart failure in patients with and without diabetes. This review summarizes the relationship between diabetes and heart failure, and informs treatment planning for the prevention of heart failure in diabetic patients.

4특집 : 당뇨병성 신증 환자의 혈당 관리

저자 : 김정미 ( Jeong Mi Kim ) , 김상수 ( Sang Soo Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 21-25 (5 pages)

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초록보기

Diabetes has reached epidemic proportions in Korea and worldwide, and is associated with increased risk for chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Given the increasing prevalence of diabetes and its high morbidity and mortality, diabetic kidney disease (DKD) represents a serious concern in individual patients and a considerable socioeconomic burden. The kidneys contribute to glucose homeostasis through processes of gluconeogenesis, glucose filtration, glucose reabsorption, and glucose consumption. Decreased nephron mass and kidney dysfunction due to DKD progression lead to the complicated state that causes both hypoglycemia and hyperglycemia. Appropriate management tailored for DKD patients is required to improve their morbidity and mortality. This review focuses on special issues related to the management of DKD, including clinical kidney outcomes in DKD progression, glycemic control indices and targets for diabetes mellitus (DM) CKD, glucose management of advanced DM CKD or ESKD and tailored medications for DKD based on clinical evidence.

5특집 : 당뇨병과 뇌졸중

저자 : 노정현 ( Junghyun Noh )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 26-37 (12 pages)

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Stroke is one of the major complications of diabetes and increases morbidity and mortality. Hyperglycemia confers increased risk of stroke occurrence. Furthermore, cardiometabolic risk factors such as hypertension and dyslipidemia frequently coexist in patients with diabetes and increase the risk of stroke. Some recent cardiovascular outcome trials of newer anti-diabetic medications have shown beneficial effects on cardiovascular complications. Prevention and improving outcomes of stroke in patients with diabetes requires proper management of hyperglycemia and additional risk factors. This review is an evidence-based approach to the epidemiology, glycemic control, effects of anti-diabetic medications on stoke, and risk factor management for prevention and improving outcomes of stroke for patients with diabetes.

6특집 : 당뇨병과 비알코올성 지방간: 진단 및 치료에 대한 고찰

저자 : 이숙정 ( Sook Jung Lee ) , 이병완 ( Byung-wan Lee )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 38-45 (8 pages)

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초록보기

The prevalence of non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of metabolic syndrome, is rapidly increasing in Korean populations and is estimated to reach 39% among Korean adults. NAFLD is one of the strongest risk factors of type 2 diabetes mellitus (T2DM), and the presence of NAFLD in T2DM patients is associated with a worse natural course of diabetic complications. The gold standard for diagnosing NAFLD is liver biopsy, which involves sampling error, high cost, and other disadvantages related to its invasive nature. We summarize non-invasive diagnostic NAFLD algorithms including biomarkers and four major imaging tools (ultrasonography, computed tomography, magnetic resonance imaging, and liver FibroScan) for diagnosing NAFLD including hepatic fibrosis. To prevent NASH (nonalcoholic steatohepatitis) or liver fibrosis, a combination of lifestyle modification with a low caloric diet and exercise, anti-diabetic agents, and non-anti-diabetic agents should be applied.

7당뇨병 교육을 위한 정보광장 : 제1형 당뇨병 당사자와 부모의 심리사회적 경험

저자 : 김미영 ( Mi Young Kim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 46-50 (5 pages)

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초록보기

Type 1 diabetes is a chronic disease that requires constant adaptation and management. Both individuals with type 1 diabetes and their parents can experience negative psychosocial effects, which can be harmful for disease management. This indicates the importance of addressing such effects. Individuals with type 1 diabetes can experience distress, irritation, depression, anxiety, fear, worries, hassle, guilt, shame, and stigma in association with their disease. Simultaneously, their parents might experience distress, depression, anxiety, posttraumatic stress disorder, burden, overwhelming responsibilities, chronic sorrow, and feelings of loss. In such cases, multidisciplinary support is required to reduce negative psychosocial effects and reinforce positive psychosocial behaviors. It is important to recognize these various emotions in patients and their parents, and health care providers should offer appropriate psychosocial support to both individuals with type 1 diabetes and their parents.

8당뇨병 교육을 위한 정보광장 : 신장 합병증이 있는 당뇨병환자에서 임상영양요법

저자 : 박서경 ( Seokyung Park )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 51-55 (5 pages)

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Diabetic nephropathy is a microvascular complication in diabetic patients and a major cause of end-stage kidney disease. Proper blood sugar control and blood pressure management can delay progression of kidney disease and can be aided by appropriate clinical nutritional therapy. As excessive protein intake affects kidney function and albuminuria, it is necessary to control protein intake. In addition, restriction of sodium intake is required as it can reduce blood pressure and albuminuria and delay the progression of kidney disease. For potassium and phosphorus, though a specific intake is not recommended, adjustments might be needed depending on stage of kidney disease and blood levels.

9당뇨병 교육을 위한 정보광장 : 당뇨병교육자와 환자 간 상호작용 변화시키기

저자 : 임성철 ( Sung-chul Lim )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 56-59 (4 pages)

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Communication between diabetes educator and patient is very important. Depending on the diabetes educator's communication style, the patient's motivation may vary. Three types of communication style are directing, following, and guiding. The purpose of this article is to compare the communication style of directing and guiding, and to help diabetes educators understand their roles through examples of conversation to help patients change their behavior.

10원저 : 스트렙토조토신 유도 당뇨병 쥐에서 돼지감자 추출물과 이눌린의 혈당과 인슐린 분비에 대한 영향

저자 : 김승희 ( Seung Hee Kim ) , 김병기 ( Byung Ki Kim ) , 박부연 ( Boo Yeun Park ) , 김정민 ( Jung Min Kim ) , 이영직 ( Young Jik Lee ) , 이미경 ( Mi Kyung Lee ) , 이성태 ( Sung-tae Yee ) , 강미연 ( Mi Yeon Kang )

발행기관 : 대한당뇨병학회 간행물 : 당뇨병(JKD) 22권 1호 발행 연도 : 2021 페이지 : pp. 60-70 (11 pages)

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Background: To determine the effects of Jerusalem Artichoke extract (JAE) and inulin on blood glucose levels and insulin secretion in streptozotocin (STZ)-induced diabetic mice.
Methods: Thirty four mice were divided into a normal control group and three experimental groups: diabetic control, JAE, and inulin. STZ (50 mg/kg) was injected intraperitoneally to induce diabetes in the three experimental groups. The JAE and inulin groups were fed 10 g/kg JAE or fed 1 g/kg inulin, respectively, for 6 weeks. Fasting glucose was checked weekly. After 6 weeks, the oral glucose tolerance test (OGTT) was performed, and the insulin level was checked.
Results: Four mice from the JAE group (n = 9) died and autopsies revealed inflammation and ulceration of skin lesions on the chest areas. Fasting glucose levels were not decreased in the inulin or JAE group relative to diabetic control group. In the OGTT at 60 minutes and 120 minutes, the serum glucose levels were significantly higher in the inulin group (572.6 ± 52.0 mg/dL and 555.8 ± 72.9 mg/dL, respectively) than in diabetic control group (484.3 ± 81.6 mg/dL and 467.3 ± 111.1 mg/dL, respectively). Insulin levels were not increased in the inulin group relative to the diabetic control group.
Conclusion: These results indicate that JAE and inulin might not be useful therapeutic strategies for diabetes mellitus and indiscreet intake of Jerusalem Artichoke could exacerbate to diabetes.

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