- Guideline/Statement/Fact Sheet
- Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends
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Kyuho Kim, Bongseong Kim, Kyuna Lee, Yu-Bae Ahn, Seung-Hyun Ko, Sung Hee Choi, Kyungdo Han, Jae-Seung Yun, on Behalf of the Committee of Public Relation of the Korean Diabetes Association
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Diabetes Metab J. 2025;49(2):183-193. Published online March 1, 2025
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DOI: https://doi.org/10.4093/dmj.2024.0836
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 Abstract
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- Background
Diabetes in older adults is becoming a significant public burden to South Korea. However, a comprehensive understanding of epidemiologic trends and the detailed clinical characteristics of older adults with diabetes is lacking. Therefore, we evaluated epidemiologic trends and the metabolic and lifestyle characteristics of diabetes in Korean older adults.
Methods
We analyzed data from the Korea National Health and Nutrition Examination Survey to assess diabetes prevalence according to diabetes duration and lifestyle behaviors. In addition, we drew upon the National Health Information Database of the National Health Insurance System to assess physical activity levels, antidiabetic medication use, polypharmacy, medication adherence, and major comorbidities.
Results
The absolute number of newly diagnosed cases of diabetes among older adults doubled over the past decade. Management rates of metabolic indicators were higher in older adults with diabetes compared to those without diabetes. The proportion of older adults with diabetes meeting the minimum recommended physical activity increased over the years. Compared to 10 years before, the use of dipeptidyl peptidase-4 inhibitor or sodium-glucose cotransporter-2 inhibitor had increased, as had comorbidities such as dyslipidemia, dementia, cancer, heart failure, atrial fibrillation, and chronic kidney disease. Initial medication adherence was significantly lower in those with end-stage kidney disease or dementia, insulin use, high-risk alcohol use, and living alone. Continuing insulin use 1 year after diagnosis of diabetes was significantly higher in those who initiated insulin therapy at diagnosis, had retinopathy, were on triple antidiabetic medications, and had a history of cancer.
Conclusion
Comprehensive management of metabolic indicators and physical activity is essential for older adults with diabetes. Improvements in prescribing guidelines, personalized management of age-related comorbidities, and individualized approaches that consider the heterogeneous nature of older adults with diabetes are desirable. Further research, such as high-quality cohort and intervention studies specific to older adults, is needed to establish evidence-based management for older adults with diabetes.
- Others
- Big Data Research for Diabetes-Related Diseases Using the Korean National Health Information Database
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Kyung-Soo Kim, Bongseong Kim, Kyungdo Han
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Diabetes Metab J. 2025;49(1):13-21. Published online January 1, 2025
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DOI: https://doi.org/10.4093/dmj.2024.0780
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Abstract
PDFSupplementary MaterialPubReader ePub
- The Korean National Health Information Database (NHID), which contains nationwide real-world claims data including sociodemographic data, health care utilization data, health screening data, and healthcare provider information, is a powerful resource to test various hypotheses. It is also longitudinal in nature due to the recommended health checkup every 2 years and is appropriate for long-term follow-up study as well as evaluating the relationships between health outcomes and changes in parameters such as lifestyle factors, anthropometric measurements, and laboratory results. However, because these data are not collected for research purposes, precise operational definitions of diseases are required to facilitate big data analysis using the Korean NHID. In this review, we describe the characteristics of the Korean NHID, operational definitions of diseases used for research related to diabetes, and introduce representative research for diabetes-related diseases using the Korean NHID.
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Citations
Citations to this article as recorded by  - Prevalence, Incidence, and Metabolic Characteristics of Young Adults with Type 2 Diabetes Mellitus in South Korea (2010–2020)
Ji Yoon Kim, Jiyoon Lee, Joon Ho Moon, Se Eun Park, Seung-Hyun Ko, Sung Hee Choi, Nam Hoon Kim
Diabetes & Metabolism Journal.2025; 49(2): 172. CrossRef
- Complications
- Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study
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Kyunghun Sung, Jae-Seung Yun, Bongseong Kim, Hun-Sung Kim, Jae-Hyoung Cho, Yong-Moon Mark Park, Kyungdo Han, Seung-Hwan Lee
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Received September 20, 2024 Accepted December 12, 2024 Published online April 5, 2025
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DOI: https://doi.org/10.4093/dmj.2024.0578
[Epub ahead of print]
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Abstract
PDFSupplementary MaterialPubReader ePub
- Background
Previous research has linked solitary living to various adverse health outcomes, but its association with diabetic complications among individuals with type 2 diabetes mellitus (T2DM) remains underexplored. We examined the risk of endstage kidney disease (ESKD) in individuals with diabetes living alone (IDLA).
Methods
This population-based cohort study used the National Health Information Database of Korea, which included 2,432,613 adults with T2DM. Household status was determined based on the number of registered family members. IDLA was defined as continuously living alone for 5 years or more. A multivariable Cox proportional hazards model was used to evaluate the association between living alone and the risk of developing ESKD.
Results
During a median follow-up of 6.0 years, 26,691 participants developed ESKD, with a higher incidence observed in the IDLA group than in the non-IDLA group. After adjusting for confounding variables, the hazard ratio for ESKD in the IDLA group was 1.10 (95% confidence interval, 1.06 to 1.14). The risk of ESKD was particularly elevated in younger individuals, those without underlying chronic kidney disease, with longer durations of living alone, and with low household income. Adherence to favorable lifestyle behaviors (no smoking, no alcohol consumption, and engaging in regular exercise) was associated with a significantly lower risk of ESKD, with a more pronounced effect in the IDLA group.
Conclusion
Living alone was associated with a higher risk of ESKD in individuals with T2DM. Tailored medical interventions and social support for IDLA are crucial for the prevention of diabetic complications.
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