Diabetes & Metabolism Journal

Original Articles

Guideline/Statement/Fact Sheet
Diabetes in Pregnancy in Korea: Prevalence, Clinical Characteristics, and Postpartum Comorbidities: Joon Ho Moon, Han Na Jung, Bongseong Kim, Seung-Hyun Ko, Soo Heon Kwak, Kyung-Do Han, Sung Hee Choi, on Behalf of the Committee of Public Relation of the Korean Diabetes Association; Diabetes Metab J. 2026;50(2):280-290. Published online March 1, 2026; DOI: https://doi.org/10.4093/dmj.2025.1161

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Abstract PDF Supplementary Material PubReader ePub: Background
Diabetes in pregnancy (DIP), encompassing gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (PGDM), has limited nationwide data in Korea. This study aimed to evaluate the clinical characteristics and management of DIP using representative national data.
Methods
Using the Korean National Health Insurance Service database, we analyzed 3,451,648 delivery records from 2013 to 2023 and 1,401,233 health examination records. The prevalence of DIP according to maternal factors, management modalities, and postpartum surveillance was examined. Long-term cardiovascular disease (CVD) risk was evaluated among 3,068,834 deliveries from 2003 to 2013 using Cox regression models.
Results
The prevalence of GDM and PGDM increased over the decade, reaching 12.4% and 2.1% in 2023. Both were more common with advancing maternal age, adiposity, and preexisting hypertension or dyslipidemia. Approximately 90% of women with GDM were managed by lifestyle modification alone, whereas 70% with PGDM received insulin monotherapy. Postpartum glycemic testing within 1 year increased from 32.0% to 42.9% for GDM and from 61.1% to 68.1% for PGDM between 2018 and 2022, though rates remained suboptimal. During a median follow-up of 13.4 to 16.2 years, CVD risk was significantly higher in women with GDM (adjusted hazard ratio [aHR], 1.47; 95% confidence interval [CI], 1.40 to 1.55) and PGDM (aHR, 3.04; 95% CI, 2.82 to 3.28) than in those without DIP.
Conclusion
The prevalence of DIP is rising in Korea, particularly among older and metabolically unhealthy women. Despite this burden, postpartum glucose surveillance remains insufficient, and DIP is linked to increased long-term cardiovascular risk, underscoring the need for improved postpartum monitoring and preventive care.

Guideline/Statement/Fact Sheet
Diabetes Fact Sheet 2025: Comparative Epidemiology and Clinical Features of Obese and Non-Obese Diabetes in Korea: Jin Hwa Kim, Bongseong Kim, Se Eun Park, Seung-Hyun Ko, Sung Hee Choi, Bong Soo Cha, Kyungdo Han, Seung-Hwan Lee, on Behalf of the Committee of Public Relation and Obese Diabetes Task Force Team of the Korean Diabetes Association; Diabetes Metab J. 2026;50(2):267-279. Published online March 1, 2026; DOI: https://doi.org/10.4093/dmj.2025.1160

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Abstract PDF Supplementary Material PubReader ePub: Background
The growing burden of obesity has profoundly influenced the epidemiology and phenotype of diabetes. This study aimed to compare the epidemiology and clinical features between obese and non-obese diabetes in Korean adults using nationwide database.
Methods
We analyzed data from the Korea National Health and Nutrition Examination Survey (2012–2023) to evaluate the prevalence and management of diabetes, as well as associated comorbidities. Data from the Korean National Health Insurance Service were used to assess antidiabetic medication use, metabolic surgery trends, and cancer outcomes.
Results
Diabetes prevalence was nearly twice as high in adults with obesity compared with those without (17.6% vs. 9.5%), with the larger difference observed in individuals aged 30 to 59 years. Obese diabetes was associated with higher rates of hypertension and dyslipidemia and lower rates of achieving glycemic, blood pressure, and lipid targets; only 21.0% achieved all three goals. Although sodium-glucose cotransporter 2 inhibitors and thiazolidinediones were more frequently prescribed in obese diabetes, overall use remained low. Metabolic surgery was less common in individuals with diabetes than in those without; sleeve gastrectomy predominated, while Roux-en-Y gastric bypass was performed more often in those with diabetes. Higher body mass index was associated with increased incidence of thyroid, breast, prostate, and kidney cancers.
Conclusion
Obese diabetes represents a distinct, high-risk phenotype in Korea, characterized by a greater cardiometabolic burden and suboptimal risk-factor control. Comprehensive management strategies integrating weight reduction with metabolic and cardiovascular risk control are essential to improve outcomes in this population.

Complications
Risk of End-Stage Kidney Disease in Individuals with Diabetes Living Alone: A Large-Scale Population-Based Study: Kyunghun Sung, Jae-Seung Yun, Bongseong Kim, Hun-Sung Kim, Jae-Hyoung Cho, Yong-Moon Mark Park, Kyungdo Han, Seung-Hwan Lee; Diabetes Metab J. 2025;49(4):862-872. Published online April 5, 2025; DOI: https://doi.org/10.4093/dmj.2024.0578

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Abstract PDF Supplementary Material PubReader 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.

Citations

Citations to this article as recorded by

Elevated triglyceride‐glucose index is associated with increased risk of chronic kidney disease and end‐stage renal disease in type 1 diabetes: Nationwide cohort study
Rosa Oh, Seohyun Kim, So Hyun Cho, Ji Yoon Kim, Myunghwa Jang, Sang Ho Park, You‐Bin Lee, Sang‐Man Jin, Kyu Yeon Hur, Gyuri Kim, Jae Hyeon Kim
Diabetes, Obesity and Metabolism.2026;[Epub] CrossRef

Guideline/Statement/Fact Sheet
Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends: 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; Diabetes Metab J. 2025;49(2):183-193. Published online March 1, 2025; DOI: https://doi.org/10.4093/dmj.2024.0836

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Abstract PDF Supplementary Material PubReader ePub

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.

Citations

Citations to this article as recorded by

Rising mortality from electrolyte and acid–base imbalances in the United States (1999–2020): a joinpoint regression analysis of national trends and disparities
Zaima Afzaal, Asma Chaudhary, Inshal Uddin Khattak, Saba Aliha, Asad Khan, Anas M Din Bashir, Hameer Ali, Amnah Khan, Aizaz Anwar Khalid, Wania Khan, Touqeer Rehman, Maryam Atif, Areen Zia, Mazia Mahnoor, Rumman Javed, Saad Ahmed Waqas, Raheel Ahmed, Soma
Annals of Medicine & Surgery.2026; 88(1): 362. CrossRef
Exploring the Lack of Physical Activity among Adolescents Worldwide
Dalmacito A. Cordero Jr.
Diabetes & Metabolism Journal.2025; 49(3): 513. CrossRef
Clinical Considerations for Safe Use of SGLT2 Inhibitors
Jae-Seung Yun, Eonju Jeon
The Journal of Korean Diabetes.2025; 26(2): 60. CrossRef
A Position Statement on Management of Diabetes in Older Adults
Jae-Seung Yun, Jin Hwa Kim, Sung Hoon Yu, Kyung Ae Lee, Hye Seung Jung, Ji Hye Heo, Jong-Ha Baek, Dong Hyeok Cho
The Journal of Korean Diabetes.2025; 26(3): 141. CrossRef
Optimizing Physical Activity Strategies for Older Adults with Diabetes
Hyeon-Jin Yu, Doyoun Hong, Kyuho Kim, Ji Hye Heo, Dong-Hyeok Cho, Yoshitaka Hashimoto, Jae-Seung Yun
Diabetes & Metabolism Journal.2025; 49(6): 1178. CrossRef

Review

Others
Big Data Research for Diabetes-Related Diseases Using the Korean National Health Information Database: Kyung-Soo Kim, Bongseong Kim, Kyungdo Han; Diabetes Metab J. 2025;49(1):13-21. Published online January 1, 2025; DOI: https://doi.org/10.4093/dmj.2024.0780

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291 Download
8 Web of Science
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Abstract PDF Supplementary Material PubReader 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.

Citations

Citations to this article as recorded by

Glucose tolerance and mortality across 24 cancer types and stages: A K‐CURE Nationwide registry study
Kyung‐Hun Sung, Jin Yu, Seyoon Kim, Mee Kyoung Kim, Yong‐Moon Mark Park, Kyungdo Han, Seung‐Hwan Lee
Diabetes, Obesity and Metabolism.2026; 28(3): 2051. CrossRef
Elevated triglyceride‐glucose index is associated with increased risk of chronic kidney disease and end‐stage renal disease in type 1 diabetes: Nationwide cohort study
Rosa Oh, Seohyun Kim, So Hyun Cho, Ji Yoon Kim, Myunghwa Jang, Sang Ho Park, You‐Bin Lee, Sang‐Man Jin, Kyu Yeon Hur, Gyuri Kim, Jae Hyeon Kim
Diabetes, Obesity and Metabolism.2026;[Epub] CrossRef
Reproductive Lifespan and Reproductive Factors in Relation to Dementia Risk in Postmenopausal Women With Type 2 Diabetes
Jin Yu, Jae-Hyoung Cho, Kyungdo Han, Yong-Moon Mark Park, Seung-Hwan Lee
Diabetes Care.2026; 49(2): 292. CrossRef
Long-term risk of offspring type 1 and type 2 diabetes following maternal gestational diabetes mellitus: a nationwide birth cohort study with 10-year follow-up
Joon Ho Moon, Han Na Jung, Bongseong Kim, Jaehyun Kim, Young Mi Jung, Hyeon Ji Kim, Jee Yoon Park, Tae Jung Oh, Soo Heon Kwak, Kyung-Do Han, Sung Hee Choi
BMC Medicine.2026;[Epub] CrossRef
Nationwide Big Data Studies of Endocrine Diseases Using the Korean National Health Information Database: Research Trends and Standardization of Operational Definitions
Sun Wook Cho, Jung Hee Kim, Kyoung Jin Kim, Beom-Jun Kim, Mee Kyoung Kim, Eun Jung Rhee
Endocrinology and Metabolism.2026; 41(1): 86. CrossRef
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
In Reply: Ischemic Stroke, Type 2 Diabetes, Glucose-Lowering Drugs, and Cardiovascular Events
Jae Hyun Bae, Jimi Choi, Nam Hoon Kim, Sin Gon Kim
Mayo Clinic Proceedings.2025; 100(7): 1255. CrossRef
Physical activity intensity and amount are inversely correlated with the risk of tuberculosis in patients with diabetes
Chiwook Chung, Kyu Na Lee, Kyungdo Han, Junhee Park, Dong Wook Shin, Sei Won Lee
Scientific Reports.2025;[Epub] CrossRef
Association of temporal MASLD with type 2 diabetes, cardiovascular disease and mortality
Eugene Han, Kyung-Do Han, Yong-ho Lee, Kyung-Soo Kim, Sangmo Hong, Jung Hwan Park, Cheol-Young Park
Cardiovascular Diabetology.2025;[Epub] CrossRef
Inverse Association Between METS-IR and Lung Cancer Risk: The Role of BMI in a Nationwide Korean Cohort
Bo-Kyung Shine, In Hwa Jeong, Minkook Son, Bongjo Kim, Sang Yi Moon, Jong Yoon Lee, Hye Ryeon Kim, Seok Jae Huh
Cancers.2025; 17(23): 3727. CrossRef
Differences in cardiovascular disease incidence according to changes in obesity status in young diabetic patients
Do Kyeong Song, Yeon-Ah Sung, Young Sun Hong, Min-ho Kim, Hyejin Lee
Cardiovascular Diabetology – Endocrinology Reports.2025;[Epub] CrossRef

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