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Dae Jung Kim  (Kim DJ) 38 Articles
Guideline/Fact Sheet
2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae Jin Kim, Hyun Min Kim, Jung Hae Ko, Nam Hoon Kim, Chong Hwa Kim, Jeeyun Ahn, Tae Jung Oh, Soo-Kyung Kim, Jaehyun Kim, Eugene Han, Sang-Man Jin, Won Suk Choi, Min Kyong Moon, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2023;47(5):575-594.   Published online September 26, 2023
DOI: https://doi.org/10.4093/dmj.2023.0282
  • 4,850 View
  • 612 Download
  • 6 Web of Science
  • 13 Crossref
AbstractAbstract PDFPubReader   ePub   
In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.

Citations

Citations to this article as recorded by  
  • Mortality in metabolic dysfunction-associated steatotic liver disease: A nationwide population-based cohort study
    Eugene Han, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Sang Hoon Ahn, Yong-ho Lee, Seung Up Kim
    Metabolism.2024; 152: 155789.     CrossRef
  • Letter by In-Kyung Jeong Regarding Article, Trends in Prevalence of Hypertriglyceridemia and Related Factors in Korean Adults: A Serial Cross-Sectional Study
    In-Kyung Jeong
    Journal of Lipid and Atherosclerosis.2024; 13(1): 80.     CrossRef
  • Association between cardiovascular disease risk and incident type 2 diabetes mellitus in individuals with prediabetes: A retrospective cohort study
    Myung Jin Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee
    Diabetes Research and Clinical Practice.2024; 208: 111125.     CrossRef
  • Korea Hypertension Fact Sheet 2023: analysis of nationwide population-based data with a particular focus on hypertension in special populations
    Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Dasom Son, Minsung Cho, Sojung Shin, Yeeun Seo, Eun-Jin kim, Song Vogue Ahn, Sun Ha Jee, Sungha Park, Hae-Young Lee, Min Ho Shin, Sang-Hyun Ihm, Seung Won Lee, Jong Ku Park, Il Suh, Tae-Yong Lee
    Clinical Hypertension.2024;[Epub]     CrossRef
  • Diabetes Duration, Cholesterol Levels, and Risk of Cardiovascular Diseases in Individuals With Type 2 Diabetes
    Mee Kyoung Kim, Kyu Na Lee, Kyungdo Han, Seung-Hwan Lee
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
  • Effect of Adding Apolipoprotein B Testing on the Prevalence of Dyslipidemia and Risk of Cardiovascular Disease in the Korean Adult Population
    Rihwa Choi, Sang Gon Lee, Eun Hee Lee
    Metabolites.2024; 14(3): 169.     CrossRef
  • A Self-powered and Supercapacitive Microneedle Continuous Glucose Monitoring System with a Wide Range of Glucose Detection Capabilities
    Hye-Jun Kil, Jang Hyeon Kim, Kanghae Lee, Tae-Uk Kang, Ju-Hyun Yoo, Yong-ho Lee, Jin-Woo Park
    Biosensors and Bioelectronics.2024; : 116297.     CrossRef
  • Management of Dyslipidemia in Patients with Diabetes Mellitus
    Kyung Ae Lee
    The Journal of Korean Diabetes.2023; 24(3): 111.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes: Recommendations for Pharmacological Treatment of Type 2 Diabetes
    Junghyun Noh
    The Journal of Korean Diabetes.2023; 24(3): 127.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes
    Min Kyong Moon
    The Journal of Korean Diabetes.2023; 24(3): 120.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes: Management of Cardiovascular Risk Factors
    Ye Seul Yang
    The Journal of Korean Diabetes.2023; 24(3): 135.     CrossRef
  • A 33-Year-Old Man Presented with Abdominal Pain and Vomiting Starting a Day Ago
    Jong Han Choi
    The Korean Journal of Medicine.2023; 98(6): 289.     CrossRef
  • Comorbidity Patterns and Management in Inpatients with Endocrine Diseases by Age Groups in South Korea: Nationwide Data
    Sung-Soo Kim, Hun-Sung Kim
    Journal of Personalized Medicine.2023; 14(1): 42.     CrossRef
Lifestyle
Ultra-Processed Food Consumption and Obesity in Korean Adults
Jee-Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim
Diabetes Metab J. 2023;47(4):547-558.   Published online April 26, 2023
DOI: https://doi.org/10.4093/dmj.2022.0026
  • 2,789 View
  • 138 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
This study aimed to investigate the association between consumption of ultra-processed foods (UPF) and obesity in Korean adults.
Methods
We included the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study baseline data of adults aged 30 to 64 years who completed a validated food frequency questionnaire. UPF was defined using the NOVA food classification. Multivariable linear and logistic regression analyses were performed to assess the association of dietary energy contribution of UPF with obesity indicators (body mass index [BMI], obesity, waist circumference [WC], and abdominal obesity).
Results
Consumption of UPF accounted for 17.9% of total energy intake and obesity and abdominal obesity prevalence was 35.4% and 30.2%, respectively. Compared with those in the lowest quartile of UPF consumption, adults in the highest quartile had greater BMI (β=0.36; 95% confidence interval [CI], 0.15 to 0.56), WC (β=1.03; 95% CI, 0.46 to 1.60), higher odds of having obesity (odds ratio [OR], 1.24; 95% CI, 1.07 to 1.45), and abdominal obesity (OR, 1.34; 95% CI, 1.14 to 1.57), after adjusting for sociodemographic characteristics, health-related behaviors, and family history of diseases. Dose-response associations between UPF consumption and obesity indicators were consistently found (all P trend <0.01). However, the strength of association was halved for all obesity indicators after further adjustments for total energy intake and overall diet quality score, and the trend toward association for obesity and WC disappeared.
Conclusion
Our finding supports the evidence that consumption of UPF is positively associated with obesity among Korean adults.

Citations

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  • Ultra-processed food consumption and increased risk of metabolic syndrome in Korean adults: A cross-sectional analysis of the KNHANES 2016–2020
    Hansol Park, Youngmi Lee, Jinah Hwang, Yujin Lee
    Nutrition.2024; 122: 112374.     CrossRef
  • Diet quality partially mediates the association between ultraprocessed food consumption and adiposity indicators
    Jee‐Seon Shim, Kyoung Hwa Ha, Dae Jung Kim, Hyeon Chang Kim
    Obesity.2023; 31(9): 2430.     CrossRef
  • Development of a Semi-Quantitative Food-Frequency Questionnaire for Korean Adults with Obesity
    Jina Chung, Seoeun Ahn, Hyojee Joung, Sangah Shin
    Nutrients.2023; 15(22): 4848.     CrossRef
Guideline/Fact Sheet
Screening for Prediabetes and Diabetes in Korean Nonpregnant Adults: A Position Statement of the Korean Diabetes Association, 2022
Kyung Ae Lee, Dae Jung Kim, Kyungdo Han, Suk Chon, Min Kyong Moon, on Behalf of the Committee of Clinical Practice Guideline of Korean Diabetes Association
Diabetes Metab J. 2022;46(6):819-826.   Published online November 24, 2022
DOI: https://doi.org/10.4093/dmj.2022.0364
  • 4,228 View
  • 268 Download
  • 4 Web of Science
  • 7 Crossref
AbstractAbstract PDFPubReader   ePub   
Diabetes screening serves to identify individuals at high-risk for diabetes who have not yet developed symptoms and to diagnose diabetes at an early stage. Globally, the prevalence of diabetes is rapidly increasing. Furthermore, obesity and/or abdominal obesity, which are major risk factors for type 2 diabetes mellitus (T2DM), are progressively increasing, particularly among young adults. Many patients with T2DM are asymptomatic and can accompany various complications at the time of diagnosis, as well as chronic complications develop as the duration of diabetes increases. Thus, proper screening and early diagnosis are essential for diabetes care. Based on reports on the changing epidemiology of diabetes and obesity in Korea, as well as growing evidence from new national cohort studies on diabetes screening, the Korean Diabetes Association has updated its clinical practice recommendations regarding T2DM screening. Diabetes screening is now recommended in adults aged ≥35 years regardless of the presence of risk factors, and in all adults (aged ≥19) with any of the risk factors. Abdominal obesity based on waist circumference (men ≥90 cm, women ≥85 cm) was added to the list of risk factors.

Citations

Citations to this article as recorded by  
  • Oxidative Balance Score and New-Onset Type 2 Diabetes Mellitus in Korean Adults without Non-Alcoholic Fatty Liver Disease: Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) Cohort
    Mid-Eum Moon, Dong Hyuk Jung, Seok-Jae Heo, Byoungjin Park, Yong Jae Lee
    Antioxidants.2024; 13(1): 107.     CrossRef
  • Efficacy and Safety of Once-Weekly Semaglutide Versus Once-Daily Sitagliptin as Metformin Add-on in a Korean Population with Type 2 Diabetes
    Byung-Wan Lee, Young Min Cho, Sin Gon Kim, Seung-Hyun Ko, Soo Lim, Amine Dahaoui, Jin Sook Jeong, Hyo Jin Lim, Jae Myung Yu
    Diabetes Therapy.2024; 15(2): 547.     CrossRef
  • Triglyceride-glucose index predicts type 2 diabetes mellitus more effectively than oral glucose tolerance test-derived insulin sensitivity and secretion markers
    Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Dongwon Yi, Mi Sook Yun, Yang Ho Kang
    Diabetes Research and Clinical Practice.2024; 210: 111640.     CrossRef
  • Cumulative muscle strength and risk of diabetes: A prospective cohort study with mediation analysis
    Shanhu Qiu, Xue Cai, Yan Liang, Wenji Chen, Duolao Wang, Zilin Sun, Bo Xie, Tongzhi Wu
    Diabetes Research and Clinical Practice.2023; 197: 110562.     CrossRef
  • Revisiting the Diabetes Crisis in Korea: Call for Urgent Action
    Jun Sung Moon
    The Journal of Korean Diabetes.2023; 24(1): 1.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association
    Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Nan Hee Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, YoonJu Song, Ye Seul Yang, Jae Hyeon Kim, You-Bin Lee, Junghyun Noh, Kyu Yeon Hur, Jong Suk Park, Sang Youl Rhee, Hae J
    Diabetes & Metabolism Journal.2023; 47(5): 575.     CrossRef
  • 2023 Clinical Practice Guidelines for Diabetes
    Min Kyong Moon
    The Journal of Korean Diabetes.2023; 24(3): 120.     CrossRef
Metabolic Risk/Epidemiology
Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study
Hyun Ho Choi, Giwoong Choi, Hojun Yoon, Kyoung Hwa Ha, Dae Jung Kim
Diabetes Metab J. 2022;46(5):803-807.   Published online January 11, 2022
DOI: https://doi.org/10.4093/dmj.2021.0236
  • 65,535 View
  • 388 Download
  • 5 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
We investigated the incidence of diagnosed diabetes in South Korean adults (aged ≥20 years) by analyzing data for the National Health Insurance Service–National Sample Cohort. From 2006 to 2015, the overall incidence rate of diagnosed diabetes decreased by approximately 0.1% per year until 2015. Although, this trend was observed in individuals aged 40 years or over, the rate increased slightly in the 20–29 and 30–39 years age groups, from 0.5 to 0.7 and 2.0 to 2.6 per 1,000 individuals, respectively. The proportion of obese young adults with diabetes increased remarkably, from 51.4% in 2006 to 72.4% in 2015. Thus, young adults need early identification and weight-control strategies to prevent diabetes.

Citations

Citations to this article as recorded by  
  • Cumulative exposure to hypertriglyceridemia and risk of type 2 diabetes in young adults
    Min-Kyung Lee, Kyungdo Han, Bongsung Kim, Jong-Dai Kim, Moon Jung Kim, Byungpyo Kim, Jung Heo, Jiyeon Ahn, Seo-Young Sohn, Jae-Hyuk Lee
    Diabetes Research and Clinical Practice.2024; 208: 111109.     CrossRef
  • Diabetes screening in South Korea: a new estimate of the number needed to screen to detect diabetes
    Kyoung Hwa Ha, Kyung Ae Lee, Kyung-Do Han, Min Kyong Moon, Dae Jung Kim
    The Korean Journal of Internal Medicine.2023; 38(1): 93.     CrossRef
  • Revisiting the Diabetes Crisis in Korea: Call for Urgent Action
    Jun Sung Moon
    The Journal of Korean Diabetes.2023; 24(1): 1.     CrossRef
  • Position Statement on the Appropriateness and Significance of Adding the Glycated Hemoglobin Test to the National Health Examination
    Ji Hye Kim, Dae Jung Kim, Jaehyun Kim, Sangjoon Park, Kyunghoon Lee, Jun Goo Kang, Eu Jeong Ku, Su Kyoung Kwon, Won Jun Kim, Young Sang Lyu, Jang Won Son, Young Sil Eom, Kyung Ae Lee, Jeongrim Lee, Jung Min Lee, Jung Hwa Lee, Jung Hwa Jung, Hochan Cho, Da
    The Journal of Korean Diabetes.2023; 24(4): 178.     CrossRef
  • Diabetes Fact Sheet in Korea 2021
    Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won
    Diabetes & Metabolism Journal.2022; 46(3): 417.     CrossRef
  • 젊은 2형 당뇨병 환자의 관리
    재현 배
    Public Health Weekly Report.2022; 15(35): 2474.     CrossRef
  • Screening for Prediabetes and Diabetes in Korean Nonpregnant Adults: A Position Statement of the Korean Diabetes Association, 2022
    Kyung Ae Lee, Dae Jung Kim, Kyungdo Han, Suk Chon, Min Kyong Moon
    Diabetes & Metabolism Journal.2022; 46(6): 819.     CrossRef
Cardiovascular Risk/Epidemiology
Performance of Diabetes and Kidney Disease Screening Scores in Contemporary United States and Korean Populations
Liela Meng, Keun-Sang Kwon, Dae Jung Kim, Yong-ho Lee, Jeehyoung Kim, Abhijit V. Kshirsagar, Heejung Bang
Diabetes Metab J. 2022;46(2):273-285.   Published online September 9, 2021
DOI: https://doi.org/10.4093/dmj.2021.0054
  • 65,535 View
  • 238 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Risk assessment tools have been actively studied, and they summarize key predictors with relative weights/importance for a disease. Currently, standardized screening scores for type 2 diabetes mellitus (DM) and chronic kidney disease (CKD)—two key global health problems—are available in United States and Korea. We aimed to compare and evaluate screening scores for DM (or combined with prediabetes) and CKD, and assess the risk in contemporary United States and Korean populations.
Methods
Four (2×2) models were evaluated in the United States-National Health and Nutrition Examination Survey (NHANES 2015–2018) and Korea-NHANES (2016–2018)—8,928 and 16,209 adults. Weighted statistics were used to describe population characteristics. We used logistic regression for predictors in the models to assess associations with study outcomes (undiagnosed DM and CKD) and diagnostic measures for temporal and cross-validation.
Results
Korean adult population (mean age 47.5 years) appeared to be healthier than United States counterpart, in terms of DM and CKD risks and associated factors, with exceptions of undiagnosed DM, prediabetes and prehypertension. Models performed well in own country and external populations regarding predictor-outcome association and discrimination. Risk tests (high vs. low) showed area under the curve >0.75, sensitivity >84%, specificity >45%, positive predictive value >8%, and negative predictive value >99%. Discrimination was better for DM, compared to the combined outcome of DM and prediabetes, and excellent for CKD due to age.
Conclusion
Four easy-to-use screening scores for DM and CKD are well-validated in contemporary United States and Korean populations. Prevention of DM and CKD may serve as first-step in public health, with these self-assessment tools as basic tools to help health education and disparity.

Citations

Citations to this article as recorded by  
  • A meta‐analysis of diabetes risk prediction models applied to prediabetes screening
    Yujin Liu, Sunrui Yu, Wenming Feng, Hangfeng Mo, Yuting Hua, Mei Zhang, Zhichao Zhu, Xiaoping Zhang, Zhen Wu, Lanzhen Zheng, Xiaoqiu Wu, Jiantong Shen, Wei Qiu, Jianlin Lou
    Diabetes, Obesity and Metabolism.2024; 26(5): 1593.     CrossRef
  • Performance Analysis and Assessment of Type 2 Diabetes Screening Scores in Patients with Non-Alcoholic Fatty Liver Disease
    Norma Latif Fitriyani, Muhammad Syafrudin, Siti Maghfirotul Ulyah, Ganjar Alfian, Syifa Latif Qolbiyani, Chuan-Kai Yang, Jongtae Rhee, Muhammad Anshari
    Mathematics.2023; 11(10): 2266.     CrossRef
  • A Comprehensive Analysis of Chinese, Japanese, Korean, US-PIMA Indian, and Trinidadian Screening Scores for Diabetes Risk Assessment and Prediction
    Norma Latif Fitriyani, Muhammad Syafrudin, Siti Maghfirotul Ulyah, Ganjar Alfian, Syifa Latif Qolbiyani, Muhammad Anshari
    Mathematics.2022; 10(21): 4027.     CrossRef
Trends and Risk Factors of Metabolic Syndrome among Korean Adolescents, 2007 to 2018 (Diabetes Metab J 2021;45:880-9)
Dae Jung Kim
Diabetes Metab J. 2022;46(2):349-350.   Published online March 24, 2022
DOI: https://doi.org/10.4093/dmj.2021.0353
  • 2,559 View
  • 124 Download
PDFPubReader   ePub   
Drug/Regimen
Cardiovascular Safety of Sodium Glucose Cotransporter 2 Inhibitors as Add-on to Metformin Monotherapy in Patients with Type 2 Diabetes Mellitus
Ja Young Jeon, Kyoung Hwa Ha, Dae Jung Kim
Diabetes Metab J. 2021;45(4):505-514.   Published online October 30, 2020
DOI: https://doi.org/10.4093/dmj.2020.0057
  • 7,853 View
  • 341 Download
  • 10 Web of Science
  • 11 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Using real-world data, cardiovascular safety was investigated in metformin users newly starting sodium glucose cotransporter 2 (SGLT2) inhibitors compared with other glucose-lowering drugs in Korea.
Methods
This was a retrospective observational study using the National Health Insurance Service claims database in Korea. The study period was from September 2014 to December 2016. The study included subjects who were newly prescribed SGLT2 inhibitors or other glucose-lowering drugs while on metformin monotherapy; cohort 1 was composed of new users of SGLT2 inhibitors versus dipeptidyl peptidase-4 (DPP-4) inhibitors and cohort 2 included new users of SGLT2 inhibitors versus sulfonylureas. To balance the patient characteristics, propensity score matching was performed at a 1:1 ratio. Cardiovascular outcomes included hospitalization for heart failure (HHF), all-cause mortality, HHF plus all-cause mortality, myocardial infarction (MI), stroke, and modified major adverse cardiovascular events (MACEs).
Results
After propensity score matching, each cohort group was well balanced at baseline (21,688 pairs in cohort 1 and 20,120 pairs in cohort 2). As the second-line treatment, use of SGLT2 inhibitors was associated with a lower risk of HHF and HHF plus all-cause mortality compared with DPP-4 inhibitors. In addition, use of SGLT2 inhibitors versus sulfonylurea as add-on therapy to metformin was associated with decreased risks of HHF, all-cause mortality, HHF plus all-cause mortality, MI, stroke, and modified MACEs.
Conclusion
SGLT2 inhibitors can be a good second-line drug to reduce the incidence of cardiovascular diseases compared with DPP-4 inhibitors or sulfonylureas in people with type 2 diabetes mellitus.

Citations

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  • Evaluation and Management of Patients With Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
    Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon
    International Journal of Heart Failure.2023; 5(1): 1.     CrossRef
  • Evaluation and Management of Patients with Diabetes and Heart Failure: A Korean Diabetes Association and Korean Society of Heart Failure Consensus Statement
    Kyu-Sun Lee, Junghyun Noh, Seong-Mi Park, Kyung Mook Choi, Seok-Min Kang, Kyu-Chang Won, Hyun-Jai Cho, Min Kyong Moon
    Diabetes & Metabolism Journal.2023; 47(1): 10.     CrossRef
  • Advances in Research on Type 2 Diabetes Mellitus Targets and Therapeutic Agents
    Jingqian Su, Yingsheng Luo, Shan Hu, Lu Tang, Songying Ouyang
    International Journal of Molecular Sciences.2023; 24(17): 13381.     CrossRef
  • Cardioprotective effects of dipeptidyl peptidase-4 inhibitors versus sulfonylureas in addition to metformin: A nationwide cohort study of patients with type 2 diabetes
    Jui Wang, Hon-Yen Wu, Kuo-Liong Chien
    Diabetes & Metabolism.2022; 48(3): 101299.     CrossRef
  • Cardiovascular disease in patients with type 2 diabetes
    Ja Young Jeon, Dae Jung Kim
    Journal of Diabetes Investigation.2022; 13(4): 614.     CrossRef
  • The Impact of Novel Anti-Diabetic Medications on CV Outcomes: A New Therapeutic Horizon for Diabetic and Non-Diabetic Cardiac Patients
    Israel Mazin, Fernando Chernomordik, Paul Fefer, Shlomi Matetzky, Roy Beigel
    Journal of Clinical Medicine.2022; 11(7): 1904.     CrossRef
  • Effect of Sodium-Glucose Cotransporter Inhibitors on Major Adverse Cardiovascular Events and Hospitalization for Heart Failure in Patients With Type 2 Diabetes Mellitus and Atrial Fibrillation
    Chang Hee Kwon, Ye-Jee Kim, Min-Ju Kim, Myung-Jin Cha, Min Soo Cho, Gi-Byoung Nam, Kee-Joon Choi, Jun Kim
    The American Journal of Cardiology.2022; 178: 35.     CrossRef
  • Using real-world data for supporting regulatory decision making: Comparison of cardiovascular and safety outcomes of an empagliflozin randomized clinical trial versus real-world data
    Ha Young Jang, In-Wha Kim, Jung Mi Oh
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Cardiovascular Safety of SGLT2 Inhibitors Compared to DPP4 Inhibitors and Sulfonylureas as the Second-Line of Therapy in T2DM Using Large, Real-World Clinical Data in Korea
    Kyuho Kim, Sung Hee Choi
    Diabetes & Metabolism Journal.2021; 45(4): 502.     CrossRef
  • The effect of sodium‐glucose transport protein 2 inhibitors on mortality and heart failure in randomized trials versus observational studies
    Jesper Krogh, Carsten Hjorthøj, Søren L. Kristensen, Christian Selmer, Steen B. Haugaard
    Diabetic Medicine.2021;[Epub]     CrossRef
  • Outcomes of patients with type 2 diabetes treated with SGLT-2 inhibitors versus DPP-4 inhibitors. An Italian real-world study in the context of other observational studies
    Enrico Longato, Benedetta Maria Bonora, Barbara Di Camillo, Giovanni Sparacino, Lara Tramontan, Angelo Avogaro, Gian Paolo Fadini
    Diabetes Research and Clinical Practice.2021; 179: 109024.     CrossRef
Guideline/Fact Sheet
2021 Clinical Practice Guidelines for Diabetes Mellitus in Korea
Kyu Yeon Hur, Min Kyong Moon, Jong Suk Park, Soo-Kyung Kim, Seung-Hwan Lee, Jae-Seung Yun, Jong Ha Baek, Junghyun Noh, Byung-Wan Lee, Tae Jung Oh, Suk Chon, Ye Seul Yang, Jang Won Son, Jong Han Choi, Kee Ho Song, Nam Hoon Kim, Sang Yong Kim, Jin Wha Kim, Sang Youl Rhee, You-Bin Lee, Sang-Man Jin, Jae Hyeon Kim, Chong Hwa Kim, Dae Jung Kim, SungWan Chun, Eun-Jung Rhee, Hyun Min Kim, Hyun Jung Kim, Donghyun Jee, Jae Hyun Kim, Won Seok Choi, Eun-Young Lee, Kun-Ho Yoon, Seung-Hyun Ko, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2021;45(4):461-481.   Published online July 30, 2021
DOI: https://doi.org/10.4093/dmj.2021.0156
  • 23,832 View
  • 1,621 Download
  • 120 Web of Science
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Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReader   ePub   
The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.

Citations

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  • Impact of Subclinical Atrial Function on the Prognosis of Patients With Atrial Fibrillation and Metabolic Syndrome
    Hyun-Jin Kim
    CardioMetabolic Syndrome Journal.2024; 4(1): 36.     CrossRef
  • Associations of omega-3 fatty acids vs. fenofibrate with adverse cardiovascular outcomes in people with metabolic syndrome: propensity matched cohort study
    Nam Hoon Kim, Ji Yoon Kim, Jimi Choi, Sin Gon Kim
    European Heart Journal - Cardiovascular Pharmacotherapy.2024; 10(2): 118.     CrossRef
  • A Multicenter, Randomized, Open-Label Study to Compare the Effects of Gemigliptin Add-on or Escalation of Metformin Dose on Glycemic Control and Safety in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Treated with Metformin and SGLT-2 Inh
    Hae Jin Kim, Jung Hyun Noh, Min Kyong Moon, Sung Hee Choi, Seung-Hyun Ko, Eun-Jung Rhee, Kyu Yeon Hur, In-Kyung Jeong, Mark Yorek
    Journal of Diabetes Research.2024; 2024: 1.     CrossRef
  • Efficacy and Safety of Once-Weekly Semaglutide Versus Once-Daily Sitagliptin as Metformin Add-on in a Korean Population with Type 2 Diabetes
    Byung-Wan Lee, Young Min Cho, Sin Gon Kim, Seung-Hyun Ko, Soo Lim, Amine Dahaoui, Jin Sook Jeong, Hyo Jin Lim, Jae Myung Yu
    Diabetes Therapy.2024; 15(2): 547.     CrossRef
  • Real-World Continuous Glucose Monitoring Data from a Population with Type 1 Diabetes in South Korea: Nationwide Single-System Analysis
    Ji Yoon Kim, Sang-Man Jin, Sarah Andrade, Boyang Chen, Jae Hyeon Kim
    Diabetes Technology & Therapeutics.2024;[Epub]     CrossRef
  • Association between Dyslipidemia and Glycated Hemoglobin in a Population-Based Study
    Purum Kang, Ka Young Kim, Hye Young Shin
    Metabolites.2024; 14(2): 92.     CrossRef
  • Outcomes of Various Classes of Oral Antidiabetic Drugs on Nonalcoholic Fatty Liver Disease
    Heejoon Jang, Yeonjin Kim, Dong Hyeon Lee, Sae Kyung Joo, Bo Kyung Koo, Soo Lim, Woojoo Lee, Won Kim
    JAMA Internal Medicine.2024; 184(4): 375.     CrossRef
  • View on Metformin: Antidiabetic and Pleiotropic Effects, Pharmacokinetics, Side Effects, and Sex-Related Differences
    Guglielmina Froldi
    Pharmaceuticals.2024; 17(4): 478.     CrossRef
  • Efficacy of intermittent short‐term use of a real‐time continuous glucose monitoring system in non‐insulin–treated patients with type 2 diabetes: A randomized controlled trial
    Sun Joon Moon, Kyung‐Soo Kim, Woo Je Lee, Mi Yeon Lee, Robert Vigersky, Cheol‐Young Park
    Diabetes, Obesity and Metabolism.2023; 25(1): 110.     CrossRef
  • Therapeutic Effects of Switching to Anagliptin from Other DPP-4 Inhibitors in T2DM Patients with Inadequate Glycemic Control: A Non-interventional, Single-Arm, Open-Label, Multicenter Observational Study
    Sang-Yong Kim, Sungrae Kim
    Diabetes Therapy.2023; 14(1): 109.     CrossRef
  • Low Skeletal Muscle Mass Accompanied by Abdominal Obesity Additively Increases the Risk of Incident Type 2 Diabetes
    Ji Eun Jun, Seung-Eun Lee, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Jae Hwan Jee, Jae Hyeon Kim
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Diabetes Metab J. 2021;45(3):459-460.   Published online May 25, 2021
DOI: https://doi.org/10.4093/dmj.2021.0084
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COVID-19
Effects of a DPP-4 Inhibitor and RAS Blockade on Clinical Outcomes of Patients with Diabetes and COVID-19
Sang Youl Rhee, Jeongwoo Lee, Hyewon Nam, Dae-Sung Kyoung, Dong Wook Shin, Dae Jung Kim
Diabetes Metab J. 2021;45(2):251-259.   Published online March 5, 2021
DOI: https://doi.org/10.4093/dmj.2020.0206
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Dipeptidyl peptidase-4 inhibitor (DPP-4i) and renin-angiotensin system (RAS) blockade are reported to affect the clinical course of coronavirus disease 2019 (COVID-19) in patients with diabetes mellitus (DM).
Methods
As of May 2020, analysis was conducted on all subjects who could confirm their history of claims related to COVID-19 in the National Health Insurance Review and Assessment Service (HIRA) database in Korea. Using this dataset, we compared the short-term prognosis of COVID-19 infection according to the use of DPP-4i and RAS blockade. Additionally, we validated the results using the National Health Insurance Service (NHIS) of Korea dataset.
Results
Totally, data of 67,850 subjects were accessible in the HIRA dataset. Of these, 5,080 were confirmed COVID-19. Among these, 832 subjects with DM were selected for analysis in this study. Among the subjects, 263 (31.6%) and 327 (39.3%) were DPP4i and RAS blockade users, respectively. Thirty-four subjects (4.09%) received intensive care or died. The adjusted odds ratio for severe treatment among DPP-4i users was 0.362 (95% confidence interval [CI], 0.135 to 0.971), and that for RAS blockade users was 0.599 (95% CI, 0.251 to 1.431). These findings were consistent with the analysis based on the NHIS data using 704 final subjects. The adjusted odds ratio for severe treatment among DPP-4i users was 0.303 (95% CI, 0.135 to 0.682), and that for RAS blockade users was 0.811 (95% CI, 0.391 to 1.682).
Conclusion
This study suggests that DPP-4i is significantly associated with a better clinical outcome of patients with COVID-19.

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    Soon Young Lee
    Journal of the Korean Medical Association.2022; 65(10): 640.     CrossRef
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    Min Kyong Moon
    The Journal of Korean Diabetes.2021; 22(4): 259.     CrossRef
Complications
Trends in Cardiovascular Complications and Mortality among Patients with Diabetes in South Korea
Jung Hwan Park, Kyoung Hwa Ha, Bo Yeon Kim, Jae Hyuk Lee, Dae Jung Kim
Diabetes Metab J. 2021;45(1):120-124.   Published online December 9, 2020
DOI: https://doi.org/10.4093/dmj.2020.0175
Correction in: Diabetes Metab J 2021;45(2):283
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
We investigated the cardiovascular complications and mortality rates of patients with diabetes in South Korea. The rates of hospitalization due to cardiovascular complications and mortality were analyzed using the Korean National Health Insurance Service-National Sample Cohort. From 2006 to 2015, the rates of hospitalization due to major cardiovascular complications decreased, while those due to heart failure (from 72 to 146 and 124 to 161 per 10,000 men and women, respectively) and peripheral artery disease (from 39 to 55 and 19 to 35 per 10,000 men and women, respectively) increased. In the period 2007 to 2015, the mortality rates for cancer, cerebrovascular disease, diabetes, heart disease, and hypertensive disease all decreased. However, the mortality rate for pneumonia increased. We observed a continuous reduction in cardiovascular complications and mortality in adults with diabetes. However, with the increase in some diabetes complications, more efforts are needed to prevent diabetes complications.

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Complications
Status of Diabetic Neuropathy in Korea: A National Health Insurance Service-National Sample Cohort Analysis (2006 to 2015)
Seong-Su Moon, Chong Hwa Kim, Seon Mee Kang, Eun Sook Kim, Tae Jung Oh, Jae-Seung Yun, Ho Chan Cho, Dae Jung Kim, Tae Sun Park
Diabetes Metab J. 2021;45(1):115-119.   Published online December 18, 2020
DOI: https://doi.org/10.4093/dmj.2020.0120
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
This report presents the status of diabetic neuropathy (DN) in Korea as determined using a National Health Insurance ServiceNational Sample Cohort (NHIS-NSC). Annual prevalences of DN were estimated by age and gender using descriptive statistics. Pharmacological treatments for DN were also analyzed. The annual prevalence of DN increased from 24.9% in 2006 to 26.6% in 2007, and thereafter, gradually subsided to 20.8% in 2015. In most cases, pharmacological treatments involved a single drug, which accounted for 91.6% of total prescriptions in 2015. The most commonly used drugs (in decreasing order) were thioctic acid, an anti-convulsive agent, or a tricyclic antidepressant. In conclusion, the prevalence of DN decreased over the 10-year study period. Thioctic acid monotherapy was usually prescribed for DN. To reduce the socio-economic burden of DN, more attention should be paid to the diagnosis of this condition and to the appropriate management of patients.

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Complications
Diabetic Retinopathy and Related Clinical Practice for People with Diabetes in Korea: A 10-Year Trend Analysis
Yoo-Ri Chung, Kyoung Hwa Ha, Kihwang Lee, Dae Jung Kim
Diabetes Metab J. 2020;44(6):928-932.   Published online July 10, 2020
DOI: https://doi.org/10.4093/dmj.2020.0096
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   

We performed a retrospective cohort study including people diagnosed with diabetes from 2006 to 2015 according to the Korean National Health Insurance Service-National Sample Cohort database, to analyze the changes in the prevalence, screening rate, and treatment patterns for diabetic retinopathy (DR) over 10 years. The proportion of people who underwent fundus screening for DR steadily increased over the past decade. The prevalence of DR increased from 13.4% in 2006 to 15.9% in 2015, while that of proliferative DR steadily decreased from 1.29% in 2006 to 1.16% in 2015. The proportion of patients undergoing retinal photocoagulation constantly decreased. The prevalence of DR increased over the past decade, while its severity seemed to have improved, with a decreased rate of proliferative DR and retinal photocoagulation. A higher proportion of patients underwent ophthalmic screening using fundus examination, but still less than 30% of patients with diabetes underwent comprehensive examination in 2015.

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    Andreas Abou Taha, Sebastian Dinesen, Anna Stage Vergmann, Jakob Grauslund
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Complications
Trends in the Incidence, Prevalence, and Mortality of End-Stage Kidney Disease in South Korea
Min-Jeong Lee, Kyoung Hwa Ha, Dae Jung Kim, Inwhee Park
Diabetes Metab J. 2020;44(6):933-937.   Published online December 23, 2020
DOI: https://doi.org/10.4093/dmj.2020.0156
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Knowledge of the epidemiologic characteristics of end-stage kidney disease (ESKD) patients is essential. The trends in the prevalence, incidence, and mortality rates of ESKD were analyzed retrospectively using the Korean National Health Insurance ServiceNational Sample Cohort database between 2006 and 2015. From 2006 to 2015, the incidence of ESKD decreased from 28.6 to 24.0 per 100,000 people and showed a decreasing pattern with or without diabetes mellitus. However, the incidence of those aged ≥75 years increased, as did the mean age at the onset of ESKD. From 2007 to 2015, the prevalence of ESKD increased in all age groups, but particularly in those aged ≥75 years. The prevalence of ESKD differed by sex and diabetes mellitus status and this gap widened over time. Mortality rates in ESKD patients remained relatively constant throughout the study period. However, mortality rates in ESKD without diabetes decreased over the same period.

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Clinical Complications
Hypoglycemia and Dementia Risk in Older Patients with Type 2 Diabetes Mellitus: A Propensity-Score Matched Analysis of a Population-Based Cohort Study
Young-Gun Kim, Dong Gyu Park, So Young Moon, Ja Young Jeon, Hae Jin Kim, Dae Jung Kim, Kwan-Woo Lee, Seung Jin Han
Diabetes Metab J. 2020;44(1):125-133.   Published online October 23, 2019
DOI: https://doi.org/10.4093/dmj.2018.0260
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AbstractAbstract PDFPubReader   
Background

Type 2 diabetes mellitus (T2DM) is associated with an increased risk for dementia. The effects of hypoglycemia on dementia are controversial. Thus, we evaluated whether hypoglycemia increases the risk for dementia in senior patients with T2DM.

Methods

We used the Korean National Health Insurance Service Senior cohort, which includes >10% of the entire senior population of South Korea. In total, 5,966 patients who had ever experienced at least one episode of hypoglycemia were matched with those who had not, using propensity score matching. The risk of dementia was assessed through a survival analysis of matched pairs.

Results

Patients with underlying hypoglycemic events had an increased risk for all-cause dementia, Alzheimer's dementia (AD), and vascular dementia (VaD) compared with those who had not experienced a hypoglycemic event (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.166 to 1.349; P<0.001 for all-cause dementia; HR, 1.264; 95% CI, 1.162 to 1.375; P<0.001 for AD; HR, 1.286; 95% CI, 1.110 to 1.490; P<0.001 for VaD). According to number of hypoglycemic episodes, the HRs of dementia were 1.170, 1.201, and 1.358 in patients with one hypoglycemic episode, two or three episodes, and more than three episodes, respectively. In the subgroup analysis, hypoglycemia was associated with an increased risk for dementia in both sexes with or without T2DM microvascular or macrovascular complications.

Conclusion

Our findings suggest that patients with a history of hypoglycemia have a higher risk for dementia. This trend was similar for AD and VaD, the two most important subtypes of dementia.

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Epidemiology
Diabetes and the Risk of Infection: A National Cohort Study
Eun Jin Kim, Kyoung Hwa Ha, Dae Jung Kim, Young Hwa Choi
Diabetes Metab J. 2019;43(6):804-814.   Published online October 21, 2019
DOI: https://doi.org/10.4093/dmj.2019.0071
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Several studies have shown that people with diabetes are vulnerable to infection. This study compared the risk of infection-related hospitalizations, intensive care unit (ICU) admission, and deaths between the person with diabetes and the general population in South Korea.

Methods

We conducted a cohort study of 66,426 diabetes and 132,852 age-sex-region-matched non-diabetes controls from the general population using a sample of data from the National Health Insurance Service-National Sample Cohort. The cohort was followed up for 9 years. Infections were classified into 17 separate categories. We used Poisson regression, with adjustment for household income and other comorbidities, to estimate incidence rate ratios (IRRs) in order to compare of infection-related hospitalizations, ICU admissions, and deaths.

Results

Compared to non-diabetes controls, diabetes group had a greater risk of almost all the types of infections considered, with the adjusted IRRs (aIRRs) for infection-related hospitalizations being the highest for hepatic abscess (aIRR, 10.17; 95% confidence interval [CI], 7.04 to 14.67), central nervous system (CNS) infections (aIRR, 8.72; 95% CI, 6.64 to 11.45), and skin and soft tissue infections other than cellulitis (SSTIs) (aIRR, 3.52; 95% CI, 3.20 to 3.88). Diabetes group also had a greater risk of ICU admission and death due to SSTIs (aIRR, 11.75; 95% CI, 7.32 to 18.86), CNS infections (aIRR, 5.25; 95% CI, 3.53 to 7.79), and bone and joint infections (aIRR, 4.78; 95% CI, 3.09 to 7.39).

Conclusion

In South Korea, people with diabetes has a considerably higher incidence of infection-related hospitalizations and deaths than the general population.

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Complications
Dipeptidyl Peptidase-4 Inhibitors versus Other Antidiabetic Drugs Added to Metformin Monotherapy in Diabetic Retinopathy Progression: A Real World-Based Cohort Study
Yoo-Ri Chung, Kyoung Hwa Ha, Hyeon Chang Kim, Sang Jun Park, Kihwang Lee, Dae Jung Kim
Diabetes Metab J. 2019;43(5):640-648.   Published online February 20, 2019
DOI: https://doi.org/10.4093/dmj.2018.0137
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

To investigate the effects of dipeptidyl peptidase-4 inhibitor (DPP4i) as add-on medications to metformin on progression of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus, compared with sulfonylurea (SU) or thiazolidinedione (TZD).

Methods

We identified 4,447 patients with DPP4i, 6,136 with SU, and 617 with TZD in addition to metformin therapy from the database of Korean National Health Insurance Service between January 2013 and December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HRs) for DR progression. The progression of DR was defined by the procedure code of panretinal photocoagulation, intravitreal injection or vitrectomy; or the addition of diagnostic code of vitreous hemorrhage, retinal detachment, or neovascular glaucoma.

Results

The age and sex-adjusted HR of DR progression was 0.74 for DPP4i add-on group compared with SU add-on group (95% confidence interval [CI], 0.62 to 0.89). This lower risk of DR progression remained significant after additional adjustments for comorbidities, duration of metformin therapy, intravitreal injections and calendar index year (HR, 0.80; 95% CI, 0.66 to 0.97).

Conclusion

This population-based cohort study showed that the use of DPP4i as add-on therapy to metformin did not increase the risk of DR progression compared to SU.

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Clinical Care/Education
2019 Clinical Practice Guidelines for Type 2 Diabetes Mellitus in Korea
Mee Kyoung Kim, Seung-Hyun Ko, Bo-Yeon Kim, Eun Seok Kang, Junghyun Noh, Soo-Kyung Kim, Seok-O Park, Kyu Yeon Hur, Suk Chon, Min Kyong Moon, Nan-Hee Kim, Sang Yong Kim, Sang Youl Rhee, Kang-Woo Lee, Jae Hyeon Kim, Eun-Jung Rhee, SungWan Chun, Sung Hoon Yu, Dae Jung Kim, Hyuk-Sang Kwon, Kyong Soo Park
Diabetes Metab J. 2019;43(4):398-406.   Published online August 20, 2019
DOI: https://doi.org/10.4093/dmj.2019.0137
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AbstractAbstract PDFPubReader   

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the 6th Clinical Practice Guidelines in 2019. Targets of glycemic, blood pressure, and lipid control in type 2 diabetes mellitus (T2DM) were updated. The obese and overweight population is increasing steadily in Korea, and half of the Koreans with diabetes are obese. Evidence-based recommendations for weight-loss therapy for obesity management as treatment for hyperglycemia in T2DM were provided. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with T2DM were incorporated into the recommendations.

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Epidemiology
Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status
Bo-Yeon Kim, Jong Chul Won, Jae Hyuk Lee, Hun-Sung Kim, Jung Hwan Park, Kyoung Hwa Ha, Kyu Chang Won, Dae Jung Kim, Kyong Soo Park
Diabetes Metab J. 2019;43(4):487-494.   Published online July 17, 2019
DOI: https://doi.org/10.4093/dmj.2019.0067
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AbstractAbstract PDFPubReader   
Background

The objective of this study was to investigate the prevalence, management, and comorbidities of diabetes among Korean adults aged 30 years and older.

Methods

This study used 2013 to 2016 data from the Korea National Health and Nutrition Examination Survey, a nationally-representative survey of the Korean population. Diabetes was defined as fasting glucose ≥126 mg/dL, current use of antidiabetic medication, a previous history of diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%.

Results

In 2016, 14.4% (approximately 5.02 million) of Korean adults had diabetes. The prevalence of impaired fasting glucose was 25.3% (8.71 million). From 2013 to 2016, the awareness, control, and treatment rates for diabetes were 62.6%, 56.7%, and 25.1%, respectively. People with diabetes had the following comorbidities: obesity (50.4%), abdominal obesity (47.8%), hypertension (55.3%), and hypercholesterolemia (34.9%). The 25.1%, 68.4%, and 44.2% of people with diabetes achieved HbA1c <6.5%, blood pressure <140/85 mm Hg, and low density lipoprotein cholesterol <100 mg/dL. Only 8.4% of people with diabetes had good control of all three targets.

Conclusion

This study confirms that diabetes is as an important public health problem. Efforts should be made to increase awareness, detection, and comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.

Citations

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Epidemiology
Development and Validation of the Korean Diabetes Risk Score: A 10-Year National Cohort Study
Kyoung Hwa Ha, Yong-ho Lee, Sun Ok Song, Jae-woo Lee, Dong Wook Kim, Kyung-hee Cho, Dae Jung Kim
Diabetes Metab J. 2018;42(5):402-414.   Published online July 6, 2018
DOI: https://doi.org/10.4093/dmj.2018.0014
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

A diabetes risk score in Korean adults was developed and validated.

Methods

This study used the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) of 359,349 people without diabetes at baseline to derive an equation for predicting the risk of developing diabetes, using Cox proportional hazards regression models. External validation was conducted using data from the Korean Genome and Epidemiology Study. Calibration and discrimination analyses were performed separately for men and women in the development and validation datasets.

Results

During a median follow-up of 10.8 years, 37,678 cases (event rate=10.4 per 1,000 person-years) of diabetes were identified in the development cohort. The risk score included age, family history of diabetes, alcohol intake (only in men), smoking status, physical activity, use of antihypertensive therapy, use of statin therapy, body mass index, systolic blood pressure, total cholesterol, fasting glucose, and γ glutamyl transferase (only in women). The C-statistics for the models for risk at 10 years were 0.71 (95% confidence interval [CI], 0.70 to 0.73) for the men and 0.76 (95% CI, 0.75 to 0.78) for the women in the development dataset. In the validation dataset, the C-statistics were 0.63 (95% CI, 0.53 to 0.73) for men and 0.66 (95% CI, 0.55 to 0.76) for women.

Conclusion

The Korean Diabetes Risk Score may identify people at high risk of developing diabetes and may be an effective tool for delaying or preventing the onset of condition as risk management strategies involving modifiable risk factors can be recommended to those identified as at high risk.

Citations

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Epidemiology
Diabetes Fact Sheet in Korea, 2016: An Appraisal of Current Status
Jong Chul Won, Jae Hyuk Lee, Jae Hyeon Kim, Eun Seok Kang, Kyu Chang Won, Dae Jung Kim, Moon-Kyu Lee
Diabetes Metab J. 2018;42(5):415-424.   Published online August 9, 2018
DOI: https://doi.org/10.4093/dmj.2018.0017
  • 8,797 View
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  • 72 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

This report presents the recent prevalence and comorbidities related to diabetes in Korea by analyzing the nationally representative data.

Methods

Using data from the Korea National Health and Nutrition Examination Survey for 2013 to 2014, the percentages and the total number of subjects over the age of 30 years with diabetes and prediabetes were estimated and applied to the National Population Census in 2014. Diagnosis of diabetes was based on fasting plasma glucose (≥126 mg/dL), current taking of antidiabetic medication, history of previous diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%. Impaired fasting glucose (IFG) was defined by fasting plasma glucose in the range of 100 to 125 mg/dL among those without diabetes.

Results

About 4.8 million (13.7%) Korean adults (≥30 years old) had diabetes, and about 8.3 million (24.8%) Korean adults had IFG. However, 29.3% of the subjects with diabetes are not aware of their condition. Of the subjects with diabetes, 48.6% and 54.7% were obese and hypertensive, respectively, and 31.6% had hypercholesterolemia. Although most subjects with diabetes (89.1%) were under medical treatment, and mostly being treated with oral hypoglycemic agents (80.2%), 10.8% have remained untreated. With respect to overall glycemic control, 43.5% reached the target of HbA1c <7%, whereas 23.3% reached the target when the standard was set to HbA1c <6.5%, according to the Korean Diabetes Association guideline.

Conclusion

Diabetes is a major public health threat in Korea, but a significant proportion of adults were not controlling their illness. We need comprehensive approaches to overcome the upcoming diabetes-related disease burden in Korea.

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Response: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46)
Kyoung Hwa Ha, Dae Jung Kim, Sungrae Kim
Diabetes Metab J. 2018;42(3):251-253.   Published online June 19, 2018
DOI: https://doi.org/10.4093/dmj.2018.0099
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  • Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study
    Hyun Ho Choi, Giwoong Choi, Hojun Yoon, Kyoung Hwa Ha, Dae Jung Kim
    Diabetes & Metabolism Journal.2022; 46(5): 803.     CrossRef
Epidemiology
Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index
Kyoung Hwa Ha, Cheol Young Park, In Kyung Jeong, Hyun Jin Kim, Sang-Yong Kim, Won Jun Kim, Ji Sung Yoon, In Joo Kim, Dae Jung Kim, Sungrae Kim
Diabetes Metab J. 2018;42(2):137-146.   Published online February 14, 2018
DOI: https://doi.org/10.4093/dmj.2018.42.2.137
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AbstractAbstract PDFPubReader   
Background

We evaluated the clinical characteristics of insulin resistance and β-cell dysfunction in newly diagnosed, drug-naive people with type 2 diabetes by analyzing nationwide cross-sectional data.

Methods

We collected the clinical data of 912 participants with newly diagnosed diabetes from 83 primary care clinics and hospitals nationwide from 2015 to 2016. The presence of insulin resistance and β-cell dysfunction was defined as a homeostatic model assessment of insulin resistance (HOMA-IR) value ≥2.5 and fasting C-peptide levels <1.70 ng/mL, respectively.

Results

A total of 75.1% and 22.6% of participants had insulin resistance and β-cell dysfunction, respectively. The proportion of participants with insulin resistance but no β-cell dysfunction increased, and the proportion of participants with β-cell dysfunction but no insulin resistance decreased as body mass index (BMI) increased. People diagnosed with diabetes before 40 years of age had significantly higher HOMA-IR and BMI than those diagnosed over 65 years of age (HOMA-IR, 5.0 vs. 3.0; BMI, 28.7 kg/m2 vs. 25.1 kg/m2). However, the β-cell function indices were lower in people diagnosed before 40 years of age than in those diagnosed after 65 years of age (homeostatic model assessment of β-cell function, 39.3 vs. 64.9; insulinogenic index, 10.3 vs. 18.7; disposition index, 0.15 vs. 0.25).

Conclusion

We observed that the main pathogenic mechanism of type 2 diabetes is insulin resistance in participants with newly diagnosed type 2 diabetes. In addition, young adults with diabetes are more likely to have higher insulin resistance with obesity and have higher insulin secretory defect with severe hyperglycemia in the early period of diabetes than older populations.

Citations

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  • A double‐blind, Randomized controlled trial on glucose‐lowering EFfects and safety of adding 0.25 or 0.5 mg lobeglitazone in type 2 diabetes patients with INadequate control on metformin and dipeptidyl peptidase‐4 inhibitor therapy: REFIND study
    Soree Ryang, Sang Soo Kim, Ji Cheol Bae, Ji Min Han, Su Kyoung Kwon, Young Il Kim, Il Seong Nam‐Goong, Eun Sook Kim, Mi‐kyung Kim, Chang Won Lee, Soyeon Yoo, Gwanpyo Koh, Min Jeong Kwon, Jeong Hyun Park, In Joo Kim
    Diabetes, Obesity and Metabolism.2022; 24(9): 1800.     CrossRef
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    Davis Kibirige, Isaac Sekitoleko, Priscilla Balungi, William Lumu, Moffat J. Nyirenda
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    Hyun Ho Choi, Giwoong Choi, Hojun Yoon, Kyoung Hwa Ha, Dae Jung Kim
    Diabetes & Metabolism Journal.2022; 46(5): 803.     CrossRef
  • A Real-World Study of Long-Term Safety and Efficacy of Lobeglitazone in Korean Patients with Type 2 Diabetes Mellitus
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    Jeong Mi Kim, Sang Soo Kim, Jong Ho Kim, Mi Kyung Kim, Tae Nyun Kim, Soon Hee Lee, Chang Won Lee, Ja Young Park, Eun Sook Kim, Kwang Jae Lee, Young Sik Choi, Duk Kyu Kim, In Joo Kim
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  • Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes
    Han Na Jang, Ye Seul Yang, Seong Ok Lee, Tae Jung Oh, Bo Kyung Koo, Hye Seung Jung
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  • Insulin Resistance versus β-Cell Failure: Is It Changing in Koreans?
    Mi-kyung Kim
    Diabetes & Metabolism Journal.2018; 42(2): 128.     CrossRef
  • Response: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J2018;42:137-46)
    Kyoung Hwa Ha, Dae Jung Kim, Sungrae Kim
    Diabetes & Metabolism Journal.2018; 42(3): 251.     CrossRef
  • Letter: Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index (Diabetes Metab J 2018;42:137-46)
    Ah Reum Khang
    Diabetes & Metabolism Journal.2018; 42(3): 249.     CrossRef
Complications
Color Doppler Ultrasonography Is a Useful Tool for Diagnosis of Peripheral Artery Disease in Type 2 Diabetes Mellitus Patients with Ankle-Brachial Index 0.91 to 1.40
Kyu Yeon Hur, Ji Eun Jun, Young Ju Choi, Yong-ho Lee, Dae Jung Kim, Seok Won Park, Byung Wook Huh, Eun Jig Lee, Sun-Ha Jee, Kap Bum Huh, Sung Hee Choi
Diabetes Metab J. 2018;42(1):63-73.   Published online February 23, 2018
DOI: https://doi.org/10.4093/dmj.2018.42.1.63
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AbstractAbstract PDFPubReader   
Background

The clinical utility of ankle-brachial index (ABI) is not clear in subjects with less severe or calcified vessel. Therefore, we investigated the usefulness of color Doppler ultrasonography for diagnosing peripheral artery disease (PAD) in type 2 diabetes mellitus (T2DM) subjects.

Methods

We analyzed 324 T2DM patients who concurrently underwent ABI and carotid intima-media thickness (CIMT) measurements and color Doppler ultrasonography from 2003 to 2006. The degree of stenosis in patients with PAD was determined according to Jager's criteria, and PAD was defined as grade III (50% to 99% stenosis) or IV stenosis (100% stenosis) by color Doppler ultrasonography. Logistic regression analysis and receiver operating characteristic curve analysis were performed to evaluate the risk factors for PAD in patients with ABI 0.91 to 1.40.

Results

Among the 324 patients, 77 (23.8%) had ABI 0.91 to 1.40 but were diagnosed with PAD. Color Doppler ultrasonography demonstrated that suprapopliteal arterial stenosis, bilateral lesions, and multivessel involvement were less common in PAD patients with ABI 0.91 to 1.40 than in those with ABI ≤0.90. A multivariate logistic regression analysis demonstrated that older age, current smoking status, presence of leg symptoms, and high CIMT were significantly associated with the presence of PAD in patients with ABI 0.91 to 1.40 after adjusting for conventional risk factors. CIMT showed significant power in predicting the presence of PAD in patients with ABI 0.91 to 1.40.

Conclusion

Color Doppler ultrasonography is a useful tool for the detection of PAD in T2DM patients with ABI 0.91 to 1.40 but a high CIMT.

Citations

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Obesity and Metabolic Syndrome
Association between Blood Mercury Level and Visceral Adiposity in Adults
Jong Suk Park, Kyoung Hwa Ha, Ka He, Dae Jung Kim
Diabetes Metab J. 2017;41(2):113-120.   Published online December 21, 2016
DOI: https://doi.org/10.4093/dmj.2017.41.2.113
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AbstractAbstract PDFPubReader   
Background

Few studies have examined the association between mercury exposure and obesity. The aim of this study is to investigate the association between blood mercury concentrations and indices of obesity in adults.

Methods

A total of 200 healthy subjects, aged 30 to 64 years, who had no history of cardiovascular or malignant disease, were examined. Anthropometric and various biochemical profiles were measured. Visceral adipose tissue (VAT) was measured using dual-energy X-ray absorptiometry (DXA).

Results

All subjects were divided into three groups according to blood mercury concentrations. Compared with the subjects in the lowest tertile of mercury, those in the highest tertile were more likely to be male; were current alcohol drinkers and smokers; had a higher body mass index (BMI), waist circumference (WC), and VAT; had higher levels of blood pressure, fasting glucose, and insulin resistance; and consumed more fish. The blood mercury concentration was significantly associated with anthropometric parameters, showing relationships with BMI, WC, and VAT. After adjusting for multiple risk factors, the odds ratios (ORs) for high mercury concentration was significantly higher in the highest VAT tertile than in the lowest VAT tertile (OR, 2.66; 95% confidence interval, 1.05 to 6.62; P<0.05).

Conclusion

The blood mercury concentration was significantly associated with VAT in healthy adults. Further studies are warranted to confirm our findings.

Citations

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Epidemiology
Serum 25-Hydroxyvitamin D Concentration Is Independently Inversely Associated with Insulin Resistance in the Healthy, Non-Obese Korean Population
So Young Ock, Kyoung Hwa Ha, Bu Kyung Kim, Hyeon Chang Kim, Jee-Seon Shim, Myung Ha Lee, Young Me Yoon, Dae Jung Kim
Diabetes Metab J. 2016;40(5):367-375.   Published online July 26, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.5.367
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

We evaluated the associations between 25-hydroxyvitamin D (25(OH)D) concentrations in serum and insulin resistance in the healthy Korean population.

Methods

We conducted this cross-sectional analysis in 1,807 healthy Korean people (628 men and 1,179 women) aged 30 to 64 years in the Cardiovascular and Metabolic Disease Etiologic Research Center study. All participants were assessed for 25(OH)D, fasting glucose, and insulin levels, and completed a health examination and lifestyle questionnaire according to standard procedures. Insulin resistance was defined as the homeostasis model assessment insulin resistance higher than the 75 percentile.

Results

Compared to those in the highest tertile (≥14.3 ng/mL), the odds ratio (OR) for insulin resistance was 1.37 (95% confidence interval [CI], 1.01 to 1.86) for the 1st tertile (<9.7 ng/mL) and 1.19 (95% CI, 0.08 to 1.62) for the 2nd tertile (9.7 to 14.3 ng/mL) after adjusting for age, gender, waist circumference, alcohol consumption, smoking status, physical exercise, season, and cohort. After stratification of the subjects by adiposity, these associations remained only in non-obese subjects (lowest tertile vs. highest tertile, multivariable OR, 1.64; 95% CI, 1.05 to 2.56).

Conclusion

Serum 25(OH)D has an independent inverse association with insulin resistance in the healthy, non-obese Korean population, even among people with vitamin D insufficiency.

Citations

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Current Status of Glycemic Control of Patients with Diabetes in Korea: The Fifth Korea National Health and Nutrition Examination Survey
Ja Young Jeon, Dae Jung Kim, Seung-Hyun Ko, Hyuk-Sang Kwon, Soo Lim, Sung Hee Choi, Chul Sik Kim, Jee Hyun An, Nan Hee Kim, Jong Chul Won, Jae Hyeon Kim, Bong-Yun Cha, Kee-Ho Song
Diabetes Metab J. 2014;38(3):197-203.   Published online June 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.3.197
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AbstractAbstract PDFPubReader   
Background

The Korea National Health and Nutrition Examination Survey (KNHANES) III (2005) reported that 22.9% of individuals with diabetes have a glycated hemoglobin (HbA1c) <6.5% and that 43.5% have an HbA1c <7%. We investigated the levels of glycemic control and the factors associated with glycemic control using data from the KNHANES V (2010 to 2012).

Methods

Subjects with diabetes diagnosed by a physician or those taking antidiabetic medications were classified as individuals with known diabetes. Of 1,498 subjects aged ≥30 years with diabetes, we excluded 157 individuals who were missing HbA1c data. A total of 1,341 subjects were included in the final analysis.

Results

The prevalence of known diabetes was 7.7% (n=1,498, estimated to be 2.32 million people). The proportions of well-controlled diabetes meeting a HbA1c goal of <6.5% and <7% were 27% and 45.6%, respectively. HbA1c increased as the duration of diabetes increased. HbA1c in subjects with a duration of diabetes ≤5 years was lower than in subjects with a duration >5 years. HbA1c in the group taking only oral hypoglycemic agents (OHAs) was significantly lower than that in the group administered only insulin or OHA and insulin in combination. In logistic regression analysis, a longer duration of diabetes, insulin use and the absence of chronic renal failure were associated with HbA1c levels >6.5%.

Conclusion

The level of adequate glycemic control was similar to but slightly improved compared with previous levels. The glycemic control of long-standing diabetes patients is more difficult even though they receive insulin treatment.

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Prevalence and Determinants of Diabetic Nephropathy in Korea: Korea National Health and Nutrition Examination Survey
Jae Hee Ahn, Ji Hee Yu, Seung-Hyun Ko, Hyuk-Sang Kwon, Dae Jung Kim, Jae Hyeon Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Kyungdo Han, Bong-Yun Cha, Nan Hee Kim
Diabetes Metab J. 2014;38(2):109-119.   Published online April 18, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.2.109
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AbstractAbstract PDFPubReader   
Background

Diabetic nephropathy is a leading cause of end stage renal disease and is associated with an increased risk of cardiovascular mortality. It manifests as albuminuria or impaired glomerular filtration rate (GFR), and the prevalence of diabetic nephropathy varies with ethnicity. The prevalence of diabetic nephropathy and its determinants in Korean adults have not previously been studied at the national level. This cross-sectional study was undertaken to ascertain the prevalence and determinants of albuminuria and chronic kidney disease (CKD) in Korean patients with diabetes.

Methods

The Korea National Health and Nutrition Examination Survey (KNHANES) V, conducted in 2011, was used to define albuminuria (n=4,652), and the dataset of KNHANES IV-V (2008-2011) was used to define CKD (n=21,521). Selected samples were weighted to represent the entire civilian population in Korea. Albuminuria was defined as a spot urine albumin/creatinine ratio >30 mg/g. CKD was defined as a GFR <60 mL/min/1.73 m2.

Results

Among subjects with diabetes, 26.7% had albuminuria, and 8.6% had CKD. Diabetes was associated with an approximate 2.5-fold increased risk of albuminuria, with virtually no difference between new-onset and previously diagnosed diabetes. Only systolic blood pressure was significantly associated with albuminuria, and old age, high serum triglyceride levels, and previous cardiovascular disease (CVD) were related with CKD in subjects with diabetes.

Conclusion

Korean subjects with diabetes had a higher prevalence of albuminuria and CKD than those without diabetes. Blood pressure was associated with albuminuria, and age, triglyceride level, and previous CVD were independent determinants of CKD in subjects with diabetes.

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Prevalence, Awareness, and Management of Obesity in Korea: Data from the Korea National Health and Nutrition Examination Survey (1998-2011)
Chul Sik Kim, Seung-Hyun Ko, Hyuk-Sang Kwon, Nan Hee Kim, Jae Hyeon Kim, Soo Lim, Sung Hee Choi, Kee-Ho Song, Jong Chul Won, Dae Jung Kim, Bong-Yun Cha
Diabetes Metab J. 2014;38(1):35-43.   Published online February 19, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.1.35
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AbstractAbstract PDFPubReader   
Background

Obesity is a risk factor for diabetes and several cardiovascular diseases. This study was to investigate the trends in the prevalence, awareness, and management status of obesity among the Korean population for recent 13 years.

Methods

The prevalence, subjective awareness, and management of obesity were investigated in adults aged ≥19 years by using the data from the Korea National Health and Nutrition Examination Surveys (KNHANES) 1998 to 2011.

Results

The number of participants was 8,117, 5,826, 5,500, 3,025, 6,756, 7,506, 6,255, and 6,155 in the KNHANES in years 1998, 2001, 2005, 2007, 2008, 2009, 2010, and 2011, respectively. The prevalence of obesity was 26.9%, 29.2%, 32.9%, 32.5%, 32.0%, 32.6%, 32.0%, and 32.0% in 1998, 2001, 2005, 2007, 2008, 2009, 2010, and 2011, respectively, while the overall prevalence of obesity and abdominal obesity increased by 1.19-fold and 1.24-fold respectively in 2011 compared against 2001. In general, a gradual increase in the prevalence of severe obesity has been observed as years go by. Furthermore, trends of improvements in obesity awareness and management rates were visible over the period of surveys.

Conclusion

Although the management status of obesity has improved during the recent years, more effective strategy to control obesity is needed.

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Higher Prevalence and Awareness, but Lower Control Rate of Hypertension in Patients with Diabetes than General Population: The Fifth Korean National Health and Nutrition Examination Survey in 2011
Seung-Hyun Ko, Hyuk-Sang Kwon, Dae Jung Kim, Jae Hyeon Kim, Nan Hee Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Kyungdo Han, Yong-Moon Park, Bong-Yun Cha
Diabetes Metab J. 2014;38(1):51-57.   Published online February 19, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.1.51
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AbstractAbstract PDFPubReader   
Background

We investigated the prevalence, awareness, treatment, and control rate of hypertension in Korean adults with diabetes using nationally representative data.

Methods

Using data of 5,105 adults from the fifth Korea National Health and Nutrition Examination Survey in 2011 (4,389 nondiabetes mellitus [non-DM]), 242 newly diagnosed with DM (new-DM), and 474 previously diagnosed with DM (known-DM), we analyzed the prevalence of hypertension (mean systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive medication) and control rate of hypertension (blood pressure [BP] <130/80 mm Hg).

Results

The prevalence of hypertension in diabetic adults was 54.6% (44.4% in new-DM and 62.6% in known-DM, P<0.0001 and P<0.0001, respectively) compared with non-DM adults (26.2%). Compared to non-DM, awareness (85.7%, P<0.001) and treatment (97.0%, P=0.020) rates were higher in known-DM, whereas no differences were found between new-DM and non-DM. Control rate among all hypertensive subjects was lower in new-DM (14.9%), compared to non-DM (35.1%, P<0.001) and known-DM (33.3%, P=0.004). Control rate among treated subjects was also lower in new-DM (25.2%), compared to non-DM (68.4%, P<0.0001) and known-DM (39.9%, P<0.0001).

Conclusion

Higher prevalence and low control rate of hypertension in adults with diabetes suggest that stringent efforts are needed to control BP in patients with diabetes, particularly in newly diagnosed diabetic patients.

Citations

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Prevalence and Management of Dyslipidemia in Korea: Korea National Health and Nutrition Examination Survey during 1998 to 2010
Eun Roh, Seung-Hyun Ko, Hyuk-Sang Kwon, Nan Hee Kim, Jae Hyeon Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Dae Jung Kim, Sung Hee Choi, Soo Lim, Bong-Yun Cha
Diabetes Metab J. 2013;37(6):433-449.   Published online December 12, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.6.433
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AbstractAbstract PDFPubReader   
Background

Dyslipidemia is a major risk factor of cardiovascular disease. The aim of this study was to investigate the changing trends in the prevalence and management status of dyslipidemia among Korean adults.

Methods

The prevalence of dyslipidemia and the rates of awareness, treatment, and control of dyslipidemia were investigated in adults aged ≥20 years from the Korea National Health and Nutrition Surveys (KNHANES) 1998 to 2010. The updated National Cholesterol Education Program criteria was used, which define dyslipidemia as having one or more of the following lipid abnormalities: hypercholesterolemia (total cholesterol ≥240 mg/dL or diagnosis of dyslipidemia or use of lipid-lowering drugs), hypertriglyceridemia (≥150 mg/dL), hyper-low density lipoprotein (LDL) cholesterolemia (≥160 mg/dL or diagnosis of dyslipidemia or use of lipid-lowering drugs), and hypo-high density lipoprotein (HDL)-cholesterolemia (<40 mg/dL in men and <50 mg/dL in women).

Results

The number of participants was 6,921, 4,894, 5,312, 2,733, 6,295, 6,900, and 5,738 in KNHANES 1998, 2001, 2005, 2007, 2008, 2009, and 2010, respectively. Age-standardized prevalence rates of dyslipidemia were 54.0%, 65.8%, 66.5%, 60.6%, 58.7%, 58.9%, and 59.0% in 1998, 2001, 2005, 2007, 2008, 2009, and 2010, respectively. Hypertriglyceridemia and hypo-HDL-cholesterolemia were the two most frequent lipid abnormalities. The overall prevalence of hypercholesterolemia and hyper-LDL-cholesterolemia increased by 1.36- and 1.35-fold in 2010 compared with 2007, respectively. Awareness, treatment, and control rates of dyslipidemia improved over the period of surveys in both sexes. In 2010, about 30% of dyslipidemic patients who received lipid-lowering treatment reached target levels.

Conclusion

Although the management status of dyslipidemia has improved during recent years, effective strategy is required for achieving better prevention, treatment, and control of dyslipidemia.

Citations

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Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c
Ja Young Jeon, Seung-Hyun Ko, Hyuk-Sang Kwon, Nan Hee Kim, Jae Hyeon Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Myoung-jin Jang, Yuna Kim, Kyungwon Oh, Dae Jung Kim, Bong-Yun Cha
Diabetes Metab J. 2013;37(5):349-357.   Published online October 17, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.5.349
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Background

Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests.

Methods

Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%.

Results

When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate.

Conclusion

We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.

Citations

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Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes "Diabetes in Korea 2007"
Ie Byung Park, Jaiyong Kim, Dae Jung Kim, Choon Hee Chung, Jee-Young Oh, Seok Won Park, Juneyoung Lee, Kyung Mook Choi, Kyung Wan Min, Jeong Hyun Park, Hyun Shik Son, Chul Woo Ahn, Hwayoung Kim, Sunhee Lee, Im Bong Lee, Injeoung Choi, Sei Hyun Baik
Diabetes Metab J. 2013;37(4):233-239.   Published online August 14, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.4.233
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AbstractAbstract PDFPubReader   

There are many studies on the prevalence, clinical characteristics, and economic burden of diabetes across the past four decades in Korea. Nonetheless, there is a dearth of nationwide study regarding diabetes encompassing all age group. Eight years ago, the Committee on the Epidemiology of Diabetes Mellitus of Korean Diabetes Association collaborated with Health Insurance Review & Assessment Service to evaluate the status of diabetes care and characteristics in diabetic patients in Korea. In 2007, the collaborative task force team published a comprehensive survey titled "Diabetes in Korea 2007." In this review, we reappraise the diabetic epidemics from the joint report and suggest further studies that are needed to be investigated in the future.

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Epidemiology of Micro- and Macrovascular Complications of Type 2 Diabetes in Korea
Jung Hee Kim, Dae Jung Kim, Hak Chul Jang, Sung Hee Choi
Diabetes Metab J. 2011;35(6):571-577.   Published online December 26, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.6.571
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AbstractAbstract PDFPubReader   

The prevalence of diabetes in Korea has increased six- to sevenfold over the past 40 years with its complications becoming major causes of morbidity and mortality. The rate of death among patients with diabetes is about twice as high as that among persons without diabetes and the most common cause of death is cardiovascular disease (30.6%). Despite the seriousness of diabetic complications, 30 to 70% of patients receive inadequate care, and only 40% of treated diabetic patients achieve the optimal control with HbA1c level <7% in Korea. In 2006, over 30 to 40% of patients with diabetes have microvascular complications and around 10% of them have macrovascular complications from our national data. Despite there are some debates about intensive glycemic control resulting in the deterioration of macrovascular complication, multifactorial treatment approaches including proper glycemic control are important to prevent diabetic complications. There have been needs for finding proper biomarkers for predicting diabetic complications properly but we still need more longitudinal studies to find this correlation with causal relationship. In this article, we wanted to review the recent status of micro- and macrovascular complications of type 2 diabetes in Korea from integration of many epidemiologic studies.

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The Relationship between Diabetes Mellitus and Health-Related Quality of Life in Korean Adults: The Fourth Korea National Health and Nutrition Examination Survey (2007-2009)
Yong Jun Choi, Min Suk Lee, So Yeon An, Tae Ho Kim, Seung Jin Han, Hae Jin Kim, Yoon-Sok Chung, Kwan Woo Lee, Dae Jung Kim
Diabetes Metab J. 2011;35(6):587-594.   Published online December 26, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.6.587
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AbstractAbstract PDFPubReader   
Background

Diabetes is a major health problem in Korea. However, interest in the quality of life in patients with diabetes is low. We examined the effects of diabetes on health-related quality of life (HRQoL) and compared it with HRQoL in the general Korean population using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) (2007-2009).

Methods

Using KNHANES IV data, we compared EuroQol (EQ)-5D and EQ-visual analogue scale (VAS) scores after adjusting for sociodemographic and psychosocial factors as well as for comorbidities (hypertension, heart disease, stroke, arthritis, and chronic renal disease). Logistic regressions were used to explore determinants for the lowest quintile HRQoL scales in the diabetes group.

Results

The mean age of the 14,441 enrolled subjects (6,129 men and 8,312 women) was 52.5±14.5 years. The mean EQ-5D and EQ-VAS scores were significantly lower in the diabetes group (EQ-5D. 0.87; EQ-VAS, 71.94) than in the non-diabetes group (EQ-5D, 0.94; EQ-VAS, 77.40) (P<0.001). Self-reported depressive symptom had a significant effect on lowering the EQ-VAS (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1 to 2.6) in the diabetes group. Stress level had a significant effect in lowering both the EQ-5D (OR, 2.0; 95% CI, 1.3 to 2.9) and the EQ-VAS (OR, 1.9; 95% CI, 1.3 to 2.9). HbA1c, diabetes duration, and treatment modalities had no significant effect on lowering HRQoL.

Conclusion

Diabetes was clearly associated with impaired HRQoL compared with the non-diabetic population regardless of comorbidities. Therapeutic approaches should focus much more on the subjective perception of health in patients with diabetes.

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The Epidemiology of Diabetes in Korea
Dae Jung Kim
Diabetes Metab J. 2011;35(4):303-308.   Published online August 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.4.303
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AbstractAbstract PDFPubReader   

Diabetes is an increasing global health problem worldwide. Diabetes and its complications have become a major cause of morbidity and mortality in Korea. The prevalence of diabetes in Korea has increased six- to seven-fold from 1.5% to 9.9% in the past 40 years. The prevalence of impaired fasting glucose also increased to about 20% in 2009. The International Diabetes Federation has estimated that the prevalence of diabetes will rise to 11.4% in 2030. Possible risk factors for diabetes in Korea are age, male gender, obesity, prediabetes, gestational diabetes, smoking, decreased physical activity, and short sleep duration. With increasing obesity, especially in childhood, and improved longevity, the prevalence of diabetes is expected to dramatically increase more than previously estimated. Therefore, public efforts to introduce healthy lifestyle changes and diabetic prevention programs are necessary to reduce the global epidemic of diabetes.

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Diabetes Metab J : Diabetes & Metabolism Journal