Diabetes & Metabolism Journal

Original Articles

Cardiovascular Risk/Epidemiology
High Waist-to-Height Ratio Increases the Risk of Cardiovascular Outcomes in Adults with Type 1 Diabetes Mellitus: A Nationwide Cohort Study: Kyeong-Jin Kim, Seohyun Kim, Rosa Oh, So Hyun Cho, Myunghwa Jang, You-Bin Lee, Gyuri Kim, Sang-Man Jin, Kyu Yeon Hur, Ji Yoon Kim, Jae Hyeon Kim; Received March 4, 2025 Accepted June 21, 2025 Published online September 4, 2025; DOI: https://doi.org/10.4093/dmj.2025.0179 [Epub ahead of print]

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Central obesity contributes to an increased risk of cardiovascular disease (CVD) and mortality. The waist-to-height ratio (WHtR) is a practical marker of central obesity across sexes, ages, and ethnicities. However, its association with comprehensive cardiovascular (CV) outcomes in patients with type 1 diabetes mellitus (T1DM) remains unclear.
Methods
From a nationwide cohort database (2006–2020), 16,928 Korean adults with T1DM were included. Participants were categorized by their WHtR values using three criteria: a three-group classification (<0.5, 0.5 to <0.6, and ≥0.6) and two binary classifications (≥0.5 vs. <0.5; ≥0.6 vs. <0.6). The primary outcomes were composite CV events, including heart failure (HF), myocardial infarction (MI), ischemic stroke, and CVD-related deaths, with each component analyzed as a secondary outcome.
Results
During a median follow-up of 6.7 years (interquartile range, 5.2 to 8.8), 4,293 composite CV events occurred. Compared to the WHtR <0.5 group, the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the composite CV outcome were 1.14 (1.05 to 1.24) in the WHtR 0.5 to <0.6 group and 1.62 (1.38 to 1.90) in the WHtR ≥0.6 group (P for trend <0.001). Increasing trends in aHRs were noted with rising WHtR values for each component of the composite outcome. Compared to the WHtR <0.6 group, the aHRs for the WHtR ≥0.6 group were as follows: HF, 1.49 (95% CI, 1.28 to 1.73); MI, 1.31 (95% CI, 1.02 to 1.68); ischemic stroke, 1.24 (95% CI, 1.02 to 1.51); and CVD-related death, 2.09 (95% CI, 1.49 to 2.92).
Conclusion
High WHtR is associated with an increased risk of CV events in adults with T1DM.

Metabolic Risk/Epidemiology
Metabolic Dysfunction-Associated Steatotic Liver Disease and Risk of Hepatocellular Carcinoma in Type 2 Diabetes Mellitus: So Hyun Cho, Gyuri Kim, Kyu-na Lee, Rosa Oh, Ji Yoon Kim, Myunghwa Jang, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Kyungdo Han, Jae Hyeon Kim; Diabetes Metab J. 2025;49(6):1298-1307. Published online July 22, 2025; DOI: https://doi.org/10.4093/dmj.2024.0641

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Background
We investigated the incidence rates of hepatocellular carcinoma (HCC) in metabolic dysfunction-associated steatotic liver disease (MASLD) categories, focusing on its association with alcohol consumption in patients with type 2 diabetes mellitus (T2DM).
Methods
This study included 2,418,858 patients with T2DM aged 20 years and older who underwent a health examination between 2009 and 2012. Participants were categorized into five groups according to hepatic steatosis, cardiometabolic risk factors, other liver diseases, and alcohol consumption. Hepatic steatosis was defined as the fatty liver index ≥30. Cox regression analysis was used to analyze the association between steatotic liver disease and development of HCC.
Results
The MASLD group showed a higher risk of HCC development regardless of alcohol consumption or presence of other liver diseases (adjusted hazard ratio [aHR], 1.38; 95% confidence interval [CI], 1.33 to 1.44). The MASLD with other combined group expressed the highest risk (aHR, 5.02; 95% CI, 4.79 to 5.27). In the metabolic dysfunction and alcohol-related steatotic liver disease and alcohol-related liver disease groups, heavy to excessive alcohol consumption increased the risk of HCC development, with a higher risk associated with greater alcohol intake (aHR, 2.40; 95% CI, 2.27 to 2.53 and aHR, 3.16; 95% CI, 2.93 to 3.41). Fine and Gray analysis also exhibited a consistent trend.
Conclusion
MASLD in patients with T2DM was associated with an increased risk of developing HCC, particularly when accompanied by other liver diseases. Moreover, alcohol consumption proportionally increased the risk of HCC with the amount of alcohol consumed.

Citations

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Telomere length and metabolic dysfunction-associated steatotic liver disease risk and progression: A systematic review and meta-analysis
Chunfeng Sun, Ping Qiu, Shuo Huang, Qihan Luo, Qing Ma, Piao Hu, Fangming Chen, Hongyan Wu, Chunxiao Chen
Experimental Gerontology.2026; 214: 113036. CrossRef

Metabolic Risk/Epidemiology
Beta-Cell Function, Insulin Sensitivity, and Metabolic Characteristics in Young-Onset Type 2 Diabetes Mellitus: Findings from Anam Diabetes Observational Study: Ji Yoon Kim, Jiyoon Lee, Sin Gon Kim, Nam Hoon Kim; Diabetes Metab J. 2025;49(6):1287-1297. Published online May 21, 2025; DOI: https://doi.org/10.4093/dmj.2024.0601

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Abstract PDF Supplementary Material PubReader ePub: Background
In this study, we aimed to determine the metabolic characteristics and changes in the early stages of young-onset type 2 diabetes mellitus (YOD) in Koreans.
Methods
From the Anam Diabetes Observational Study cohort (2017–2023), the characteristics of newly diagnosed YOD (<40 years of age, n=39) and later-onset (≥40 years of age) type 2 diabetes mellitus (LOD, n=178) were compared at diagnosis and 1 year later. All participants underwent an oral glucose tolerance test at diagnosis and annually thereafter. β-Cell function was determined using the disposition index (DI), calculated as the insulinogenic index×Matsuda insulin sensitivity index (ISI). Insulin sensitivity was determined using ISI and homeostasis model assessment of insulin resistance (HOMA2-IR).
Results
Mean (±standard deviation) age of individuals with YOD was 29.8±6.4 years, and 76.9% were male. YOD patients had higher body mass index (29.8 kg/m² vs. 27.2 kg/m², P=0.020), fat mass (30.5 kg vs. 24.1 kg, P=0.011), fatty liver index (65.4 vs. 49.2, P=0.005), and glycosylated hemoglobin (HbA1c) level at diagnosis (9.3% vs. 7.7%, P<0.001) compared with LOD patients. YOD patients exhibited lower insulin sensitivity (ISI: 2.79 vs. 3.26, P=0.008; HOMA2-IR: 2.72 vs. 1.83, P<0.001) and β-cell function (DI) at diagnosis (0.41 vs. 0.72, P=0.003) than LOD patients. Following 1 year of treatment, DI improved by 94% in YOD along with improvement in HbA1c; however, it was still significantly lower than that of LOD (0.64 vs. 0.90, P=0.017).
Conclusion
Individuals with YOD have unfavorable metabolic characteristics, substantially reduced insulin sensitivity, and decompensated β-cell function at disease onset, which persist even after treatment.

Corrigendum

Diabetes Fact Sheets in Korea 2024: Se Eun Park, Seung-Hyun Ko, Ji Yoon Kim, Kyuho Kim, Joon Ho Moon, Nam Hoon Kim, Kyung Do Han, Sung Hee Choi, Bong Soo Cha; Diabetes Metab J. 2025;49(3):524-524. Published online May 1, 2025; DOI: https://doi.org/10.4093/dmj.2024.0818.c1; Corrects: Diabetes Metab J 2025;49(1):24

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Impact of smart watch mobile application on the risk treatment of type 2 diabetes mellitus (iSMART-DM)
Min Kyoung Jang, Yun Kyung Cho, Jung Yoon Moon, Se Hee Min, Ju Hee Hwang, Chang Hee Jung
Primary Care Diabetes.2026; 20(1): 47. CrossRef
Real‐World Evidence of Long‐Term Dulaglutide Use: Sustained Glycemic and Weight Improvements Beyond Three Years
Hwi Seung Kim, Myung Jin Kim, Hee Sung Kim, Yun Kyung Cho, Chang Hee Jung, Woo Je Lee
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Impact of Hospitalist-Led Care on Glycemic Control Among Hospitalized Adults with Diabetes in Korea
Soohyun Lee, Jaewoong Kim, Areum Shin, Sunhee Jo, Chul Sik Kim, Taeyoung Kyong
Journal of Clinical Medicine.2026; 15(2): 406. CrossRef
Diabetes Fact Sheet 2025: Special Edition on Diabetes with Obesity and in Pregnancy
Se Eun Park, Se Hee Min, Jin Hwa Kim, Seung-Hwan Lee, Han Na Jung, Joon Ho Moon, Kyungdo Han, Seung-Hyun Ko, Bong Soo Cha, Sung Hee Choi
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Efficacy and Safety of Fixed‐Dose Combinations of Sitagliptin and Empagliflozin as Add‐On to Metformin in Korean Patients With Type 2 Diabetes: A Randomised, Double‐Blind, Multi‐Centre, Placebo‐Controlled, Phase III Trial
Soo Lim, Tae Nyun Kim, Ji Oh Mok, Choon Hee Chung, You Cheol Hwang, Ho Chan Cho, Jong Chul Won, Eonju Jeon, Eun Seok Kang, Ki Young Lee, Chong Hwa Kim, Soo Heon Kwak, Cheol Young Park, Kang Seo Park, Sang Yong Kim, Jae Hyuk Lee, Soon Hee Lee, Dong Hyeok C
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Association between extracellular-to-intracellular water ratio and type 2 diabetes mellitus in Korean males aged 19-80 years: analysis of KNHANES 2022-2023
Seung-Hee Lee, Seo-Jeong Heo, Jonghoon Park
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Clinically Practical and Affordable Lifestyle Modification to Prevent Diabetes Mellitus in Real Practice
Inji Lee, Minji Kang, Ji Hye Choi, Hyunjung Lim, Suk Chon
Diabetes & Metabolism Journal.2025; 49(5): 951. CrossRef

Original Articles

Technology/Device
Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population–Pronounced Age-Related Disparities: Nationwide Cohort Study: Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim; Diabetes Metab J. 2025;49(5):1040-1050. Published online April 28, 2025; DOI: https://doi.org/10.4093/dmj.2024.0804

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Background
This study aims to identify the status of continuous glucose monitoring (CGM) use among individuals with type 1 diabetes mellitus (T1DM) in South Korea and to investigate whether age-related disparities exist.
Methods
Individuals with T1DM receiving intensive insulin therapy were identified from the Korean National Health Insurance Cohort (2019–2022). Characteristics of CGM users and non-users were compared, and the prescription rates of CGM and sensor- augmented pump (SAP) or automated insulin delivery (AID) systems according to age groups (<19, 19–39, 40–59, and ≥60 years) were analyzed using chi-square tests. Glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CV) among CGM users were also examined.
Results
Among the 56,908 individuals with T1DM, 10,822 (19.0%) used CGM at least once, and 6,073 (10.7%) used CGM continuously. Only 241 (0.4%) individuals utilized either SAP or AID systems. CGM users were younger than non-users. The continuous prescription rate of CGM was highest among individuals aged <19 years (37.0%), followed by those aged 19–39 years (15.8%), 40–59 years (10.7%), and ≥60 years (3.9%) (P<0.001 for between-group differences). Among CGM users, HbA1c levels decreased from 8.7%±2.4% at baseline to 7.2%±1.2% at 24 months, and CV decreased from 36.6%±11.9% at 3 months to 34.1%±12.7% at 24 months.
Conclusion
Despite national reimbursement for CGM devices, the prescription rates of CGM remain low, particularly among older adults. Given the improvements in HbA1c and CV following CGM initiation, more efforts are needed to increase CGM utilization and reduce age-related disparities.

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Association of perceived diabetes stigma with time below range <3.0 mmol/L and anxiety in adults with type 1 diabetes using continuous glucose monitoring
Seohyun Kim, Soojin Park, Sang‐Man Jin, Jae Hyeon Kim, Gyuri Kim
Diabetic Medicine.2026;[Epub] CrossRef
Suboptimal adoption of diabetes technology despite coverage and the impact on glycemic outcomes in children and adolescents with type 1 diabetes in Hong Kong
Sarah Wing-yiu Poon, Kwong-tat Chan, Betty Wai-man But, Shirley Man-yee Wong, Wing-in Yam, Pik-to Cheung, Wing-shan See, Suk-yan Chan, Ho-chung Yau, Eunice Wai Yu Wong, Lap Ming Wong, Antony Chun-cheung Fu, Elaine Yin-wah Kwan, Janez Heung-ching Tsui, Sin
Journal of Pediatric Endocrinology and Metabolism.2026; 39(3): 251. CrossRef
Preliminary clinical outcomes and adoption of continuous glucose monitoring following reimbursement implementation in patients with type 1 diabetes in Thailand
Nichapa Yordsudueam, Nattakarn Numsriskulrat, Worapimon Lerdrassameethad, Pattayarporn Paleekul, Jutipond jitchana, Nitchakarn Laichuthai, Taninee Sahakitrungruang
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Challenges and Opportunities for Improving Care for Type 1 Diabetes in Older Adulthood
Anna R. Kahkoska, Joshua J. Neumiller, Anastasia-Stefania Alexopoulos, Amlan Barik, Elbert S. Huang, Lori M. Laffel, Naushira Pandya, Christine Slyne, Elena Toschi, Ruth S. Weinstock, Medha Munshi
Diabetes Care.2026; 49(4): 559. CrossRef
Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetologia.2026;[Epub] CrossRef
Sequential use of continuous glucose monitoring, with or without exercise trackers, significantly improves glycemic control in patients with type 2 diabetes
Anushka Lahiri, Suan Tee Lim, Htike Kyu, Yock Young Dan, Chin Meng Khoo
Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef
Efficacy and Safety of Stage 5 Connected Insulin Pens in Type 1 or Type 2 Diabetes: Randomized Controlled Trial Protocol
Ji Yoon Kim, Nam Hoon Kim, Soo Heon Kwak, Chang Hee Jung, Eun Seok Kang, Jun Sung Moon, Sun Joon Moon, So Yoon Kwon, Jee Hee Yoo, Younghoon Kim, Tae-min Lee, Chung-il Yang, Jae Hyeon Kim, Sang-Man Jin
Endocrinology and Metabolism.2025;[Epub] CrossRef

Guideline/Statement/Fact Sheet
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 Metab J. 2025;49(2):172-182. Published online March 1, 2025; DOI: https://doi.org/10.4093/dmj.2024.0826

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Background
This study aimed to examine trends in the prevalence, incidence, metabolic characteristics, and management of type 2 diabetes mellitus (T2DM) among young adults in South Korea.
Methods
Young adults with T2DM were defined as individuals aged 19 to 39 years who met the diagnostic criteria for T2DM. Data from the Korean National Health Insurance Service-Customized Database (2010–2020, n=225,497–372,726) were analyzed to evaluate trends in T2DM prevalence, incidence, metabolic profiles, comorbidities, and antidiabetic drug prescription. Additional analyses were performed using the Korea National Health and Nutrition Examination Survey.
Results
The prevalence of T2DM in young adults significantly increased from 1.02% in 2010 to 2.02% in 2020 (P<0.001), corresponding to 372,726 patients in 2020. Over the same period, the incidence rate remained stable within the range of 0.36% to 0.45%. Prediabetes prevalence steadily increased from 15.53% to 20.92%, affecting 3.87 million individuals in 2020. The proportion of young adults with T2DM who were obese also increased, with 67.8% having a body mass index (BMI) ≥25 kg/m² and 31.6% having a BMI ≥30 kg/m² in 2020. The prevalence of hypertension, dyslipidemia, and fatty liver disease also increased, reaching 34.2%, 79.8%, and 78.9%, respectively, in 2020. Although the overall pharmacological treatment rate remained low, the prescription of antidiabetic medications with weight-reducing properties increased over the study period.
Conclusion
The prevalence of T2DM among young adults in South Korea nearly doubled over the past decade. The strong association with obesity and metabolic comorbidities emphasizes the urgent need for targeted prevention and management strategies tailored to this population.

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Diabetology & Metabolic Syndrome.2026;[Epub] CrossRef
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
Diabetes & Metabolism Journal.2026; 50(2): 267. CrossRef
Diabetes Fact Sheet 2025: Special Edition on Diabetes with Obesity and in Pregnancy
Se Eun Park, Se Hee Min, Jin Hwa Kim, Seung-Hwan Lee, Han Na Jung, Joon Ho Moon, Kyungdo Han, Seung-Hyun Ko, Bong Soo Cha, Sung Hee Choi
Diabetes & Metabolism Journal.2026; 50(2): 255. 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
Fenofibrate therapy and risk of heart failure outcomes in patients with Type 2 diabetes: a propensity-matched cohort study
Ji Yoon Kim, Nam Hoon Kim, Jiyoon Lee, Dong-Hoon Kim, Sin Gon Kim
European Heart Journal - Cardiovascular Pharmacotherapy.2025; 11(7): 620. CrossRef
Young Adults at Risk: Tackling the Surge of Early‑Onset Type 2 Diabetes in Korea
Eun-Hee Cho
Endocrinology and Metabolism.2025; 40(4): 542. CrossRef
Young patients with type 2 diabetes have high relative risks for complications in a country with middle-high sociodemographic index, similarly to those countries with high index
Gergő A. Molnár, Zoltán Kiss, István Wittmann
Frontiers in Endocrinology.2025;[Epub] CrossRef
Cost-Effectiveness Analysis of Real-Time Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in People With Type 2 Diabetes Treated With Non-Intensive Insulin Therapy in South Korea
Ji Yoon Kim, Sabrina Ilham, Hamza Alshannaq, Richard F. Pollock, Martin Field, Gregory J. Norman, Sang-Man Jin, Jae Hyeon Kim
Journal of Diabetes Science and Technology.2025;[Epub] CrossRef
Can screening for albuminuria detect type 2 diabetes mellitus?
Mi Kyung Kim
Kidney Research and Clinical Practice.2025; 44(6): 857. CrossRef
Association between severe acute pancreatitis and new-onset diabetes: a propensity score-matched real-world study
Djibril M. Ba, Phil A. Hart, Tian Qiu, Somashekar G. Krishna, Xiang Gao, Douglas L. Leslie, David Bradley, Jennifer Maranki, Kadiyatu Fofana, Vernon M. Chinchilli, Ariana R. Pichardo-Lowden
Frontiers in Endocrinology.2025;[Epub] CrossRef

Technology/Device
Comparison of Real-Time and Intermittently-Scanned Continuous Glucose Monitoring for Glycemic Control in Type 1 Diabetes Mellitus: Nationwide Cohort Study: Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim; Diabetes Metab J. 2025;49(3):436-447. Published online February 27, 2025; DOI: https://doi.org/10.4093/dmj.2024.0160

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Background
This study compares the association between real-time continuous glucose monitoring (rtCGM) and intermittently- scanned CGM (isCGM) and glycemic control in individuals with type 1 diabetes mellitus (T1DM) in a real-world setting.
Methods
Using data from the Korean National Health Insurance Service Cohort, individuals with T1DM managed by intensive insulin therapy were followed at 3-month intervals for 2 years after the initiation of CGM. The glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CVs) of rtCGM and isCGM users were compared using independent two-sample t-test and a linear mixed model.
Results
The analyses considered 7,786 individuals (5,875 adults aged ≥19 years and 1,911 children and adolescents aged <19 years). Overall, a significant reduction in HbA1c level was observed after 3 months of CGM, and the effect was sustained for 2 years. The mean HbA1c level at baseline was higher in rtCGM users than in isCGM users (8.9%±2.7% vs. 8.6%±2.2%, P<0.001). However, from 3 to 24 months, rtCGM users had lower HbA1c levels than isCGM users at every time point (7.1%±1.2% vs. 7.5%±1.3% at 24 months, P<0.001 for all time points). In both adults and children, the greater reduction in HbA1c with rtCGM remained significant after adjusting for the baseline characteristics of the users. The CV also showed greater decrease with rtCGM than with isCGM.
Conclusion
In this large nationwide cohort study, the use of rtCGM was associated with a greater improvement in glycemic control, including HbA1c reduction, than the use of isCGM in both adults and children with T1DM.

Citations

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EMERGING DIGITAL TECHNOLOGIES IN MONITORING ENDOCRINE DISORDERS: CONTINUOUS GLUCOSE MONITORING SYSTEMS AND ARTIFICIAL INTELLIGENCE IN THE DIAGNOSIS OF POLYCYSTIC OVARY SYNDROME
Aleksandra Ćwirko-Godycka, Nikola Murawska, Michalina Chodór, Aleksandra Tomaszewska, Kinga Karczewska, Sonia Mojzyk, Maciej Kokoszka, Aleksandra Mierniczek, Natalia Dymel, Ryszard Feret
International Journal of Innovative Technologies in Social Science.2026;[Epub] CrossRef
Dementia Risk in Type 1 and 2 Diabetes: A Nationwide Population‐Based Comparison
Ji Eun Jun, Seohyun Kim, In‐Kyung Jeong, Jae Hyeon Kim
Diabetes, Obesity and Metabolism.2026;[Epub] CrossRef
Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetologia.2026;[Epub] CrossRef
Beneficial Analysis for Glucose Variability by Continuous Glucose Monitoring (CGM)
Sanae Mima, Hiroshi Bando, Akemi Tamura, Yukari Okino, Takumi Yamada, Yoshiyuki Abe
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Yan Wang, Zhaoran Wang, Wenya Diao, Tong Shi, Jiahe Xu, Tiantian Deng, Chaoying Wen, Jienan Gu, Tingting Deng, Sixuan Wang, Cheng Xiao
Clinical Reviews in Allergy & Immunology.2025;[Epub] CrossRef
Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications
Hwa Young Kim, Jaehyun Kim
Clinical and Experimental Pediatrics.2025; 68(11): 842. CrossRef
Dispositivi indossabili per la gestione del diabete
Filippo CARLUCCI, Antonella TABUCCHI, Marcello FIORINI, Lucrezia GALASSO, Alessandro TERRENI
Biochimica Clinica.2025;[Epub] CrossRef
Efficacy and Safety of Stage 5 Connected Insulin Pens in Type 1 or Type 2 Diabetes: Randomized Controlled Trial Protocol
Ji Yoon Kim, Nam Hoon Kim, Soo Heon Kwak, Chang Hee Jung, Eun Seok Kang, Jun Sung Moon, Sun Joon Moon, So Yoon Kwon, Jee Hee Yoo, Younghoon Kim, Tae-min Lee, Chung-il Yang, Jae Hyeon Kim, Sang-Man Jin
Endocrinology and Metabolism.2025;[Epub] CrossRef

Guideline/Statement/Fact Sheet
Diabetes Fact Sheets in Korea 2024: Se Eun Park, Seung-Hyun Ko, Ji Yoon Kim, Kyuho Kim, Joon Ho Moon, Nam Hoon Kim, Kyung Do Han, Sung Hee Choi, Bong Soo Cha; Diabetes Metab J. 2025;49(1):24-33. Published online January 1, 2025; DOI: https://doi.org/10.4093/dmj.2024.0818; Correction in: Diabetes Metab J 2025;49(3):524

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Background
This study aimed to investigate the prevalence, management, and comorbidities of diabetes mellitus among Korean adults.
Methods
Data from the Korea National Health and Nutrition Examination Survey (2019–2022) were analyzed to assess the prevalence, treatment, risk factors, and comorbidities of diabetes. Comparisons between young and older adults with diabetes were emphasized.
Results
Among Korean adults aged ≥30 years, the prevalence of diabetes is 15.5% during 2021–2022. Of these, 74.7% were aware of their condition, 70.9% received antidiabetic treatment, and only 32.4% achieved glycosylated hemoglobin (HbA1c) <6.5%. Moreover, 15.9% met the integrated management targets, which included HbA1c <6.5%, blood pressure <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL. In young adults aged 19 to 39 years, the prevalence of diabetes was 2.2%. Among them, 43.3% were aware of their condition, 34.6% received treatment, and 29.6% achieved HbA1c <6.5%. Obesity affected 87.1%, and 26.9% had both hypertension and hypercholesterolemia. Among adults aged ≥65 years, the prevalence of diabetes was 29.3%, with awareness, treatment, and control rates of 78.8%, 75.7%, and 31.2%, respectively. Integrated management targets (HbA1c <7.5%, hypertension, and lipids) were achieved by 40.1%.
Conclusion
Diabetes mellitus remains highly prevalent among Korean adults, with significant gaps in integrated glycemic, blood pressure, and lipid control. Older adults with diabetes show higher awareness and treatment rates but limited integrated management outcomes. Young adults with diabetes bear a significant burden of obesity and comorbidities, alongside low awareness and treatment rates. Therefore, early intervention programs, education, and strategies tailored to younger populations are urgently required.

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Brief Report

Technology/Device
Effectiveness of Predicted Low-Glucose Suspend Pump Technology in the Prevention of Hypoglycemia in People with Type 1 Diabetes Mellitus: Real-World Data Using DIA:CONN G8: Jee Hee Yoo, Ji Yoon Kim, Jae Hyeon Kim; Diabetes Metab J. 2025;49(1):144-149. Published online August 28, 2024; DOI: https://doi.org/10.4093/dmj.2024.0039

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We evaluated the effectiveness of the predictive low-glucose suspend (PLGS) algorithm in the DIA:CONN G8. Forty people with type 1 diabetes mellitus (T1DM) who used a DIA:CONN G8 for at least 2 months with prior experience using pumps without and with PLGS were retrospectively analyzed. The objective was to assess the changes in time spent in hypoglycemia (percent of time below range [%TBR]) before and after using PLGS. The mean age, sensor glucose levels, glucose threshold for suspension, and suspension time were 31.1±22.8 years, 159.7±23.2 mg/dL, 81.1±9.1 mg/dL, and 111.9±79.8 min/day, respectively. Overnight %TBR <70 mg/dL was significantly reduced after using the algorithm (differences=0.3%, from 1.4%±1.5% to 1.1%±1.2%, P=0.045). The glycemia risk index (GRI) improved significantly by 4.2 (from 38.8±20.9 to 34.6±19.0, P=0.002). Using the PLGS did not result in a change in the hyperglycemia metric (all P>0.05). Our findings support the PLGS in DIA:CONN G8 as an effective algorithm to improve night-time hypoglycemia and GRI in people with T1DM.

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Scoping review of subcutaneous glucose monitoring techniques
Eva Hrubá, Jan Kubíček, Martin Augustynek
Measurement.2026; 261: 119940. CrossRef
Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population–Pronounced Age-Related Disparities: Nationwide Cohort Study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetes & Metabolism Journal.2025; 49(5): 1040. CrossRef

Original Articles

Pathophysiology
Recent Glycemia Is a Major Determinant of β-Cell Function in Type 2 Diabetes Mellitus: Ji Yoon Kim, Jiyoon Lee, Sin Gon Kim, Nam Hoon Kim; Diabetes Metab J. 2024;48(6):1135-1146. Published online June 17, 2024; DOI: https://doi.org/10.4093/dmj.2023.0359

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Background
Progressive deterioration of β-cell function is a characteristic of type 2 diabetes mellitus (T2DM). We aimed to investigate the relative contributions of clinical factors to β-cell function in T2DM.
Methods
In a T2DM cohort of 470 adults (disease duration 0 to 41 years), β-cell function was estimated using insulinogenic index (IGI), disposition index (DI), oral disposition index (DIO), and homeostasis model assessment of β-cell function (HOMA-B) derived from a 75 g oral glucose tolerance test (OGTT). The relative contributions of age, sex, disease duration, body mass index, glycosylated hemoglobin (HbA1c) levels (at the time of the OGTT), area under the curve of HbA1c over time (HbA1c AUC), coefficient of variation in HbA1c (HbA1c CV), and antidiabetic agents use were compared by standardized regression coefficients. Longitudinal analyses of these indices were also performed.
Results
IGI, DI, DI_O, and HOMA-B declined over time (P<0.001 for all). Notably, HbA1c was the most significant factor affecting IGI, DI, DIO, and HOMA-B in the multivariable regression analysis. Compared with HbA1c ≥9%, DI was 1.9-, 2.5-, 3.7-, and 5.5-fold higher in HbA1c of 8%–<9%, 7%–<8%, 6%–<7%, and <6%, respectively, after adjusting for confounding factors (P<0.001). Conversely, β-cell function was not affected by the type or duration of antidiabetic agents, HbA1c AUC, or HbA1c CV. The trajectories of the IGI, DI, DIO, and HOMA-B mirrored those of HbA1c.
Conclusion
β-Cell function declines over time; however, it is flexible, being largely affected by recent glycemia in T2DM.

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An interpretable machine learning model for predicting metabolic dysfunction‐associated steatotic liver disease in patients with type 2 diabetes
Zhuolin Zhou, Nan Gao, Jiaojiao Liu, Xuerong Ma, Zhijuan Ge, Cheng Ji
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Machine learning and engagement insights for personalized blood glucose management
Inbar Breuer Asher, David L. Horwitz, Omar Manejwala, Yifat Fundoiano-Hershcovitz
Frontiers in Digital Health.2026;[Epub] CrossRef
Redefining β-Cell Function in Type 2 Diabetes Mellitus: From Comprehensive Assessment to Precision Medicine
YongKyung Kim, Joon Ha, Jun Sung Moon
Diabetes & Metabolism Journal.2026; 50(2): 235. CrossRef
Synergistic benefit of thiazolidinedione and sodium-glucose cotransporter 2 inhibitor for metabolic dysfunction-associated steatotic liver disease in type 2 diabetes: a 24-week, open-label, randomized controlled trial
Minyoung Lee, Sukchul Hong, Yongin Cho, Hyungjin Rhee, Min Heui Yu, Jaehyun Bae, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha
BMC Medicine.2025;[Epub] CrossRef
Beta-Cell Function, Insulin Sensitivity, and Metabolic Characteristics in Young-Onset Type 2 Diabetes Mellitus: Findings from Anam Diabetes Observational Study
Ji Yoon Kim, Jiyoon Lee, Sin Gon Kim, Nam Hoon Kim
Diabetes & Metabolism Journal.2025; 49(6): 1287. CrossRef
Unlocking Gut-Driven Metabolic Repair: The Role of Glucomannan Porang (Amorphophallus muelleri Blume) in Insulin Resistance and Short-Chain Fatty Acid Modulation in a Type 2 Diabetes Mellitus Rat Model
Azizah H. Safitri, Rahmata A. Sayyida, Eni Widayati, Nurina Tyagita
Tropical Journal of Natural Product Research.2025;[Epub] CrossRef
The Importance of Treating Hyperglycemia in β-Cell Dysfunction of Type 2 Diabetes Mellitus
Arim Choi, Kyung-Soo Kim
Diabetes & Metabolism Journal.2024; 48(6): 1056. CrossRef

Cardiovascular Risk/Epidemiology
Comparison of on-Statin Lipid and Lipoprotein Levels for the Prediction of First Cardiovascular Event in Type 2 Diabetes Mellitus: Ji Yoon Kim, Jimi Choi, Sin Gon Kim, Nam Hoon Kim; Diabetes Metab J. 2023;47(6):837-845. Published online August 23, 2023; DOI: https://doi.org/10.4093/dmj.2022.0217

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Background
A substantial cardiovascular disease risk remains even after optimal statin therapy. Comparative predictiveness of major lipid and lipoprotein parameters for cardiovascular events in patients with type 2 diabetes mellitus (T2DM) who are treated with statins is not well documented.
Methods
From the Korean Nationwide Cohort, 11,900 patients with T2DM (≥40 years of age) without a history of cardiovascular disease and receiving moderate- or high-intensity statins were included. The primary outcome was the first occurrence of major adverse cardiovascular events (MACE) including ischemic heart disease, ischemic stroke, and cardiovascular death. The risk of MACE was estimated according to on-statin levels of low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), highdensity lipoprotein cholesterol (HDL-C), and non-HDL-C.
Results
MACE occurred in 712 patients during a median follow-up period of 37.9 months (interquartile range, 21.7 to 54.9). Among patients achieving LDL-C levels less than 100 mg/dL, the hazard ratios for MACE per 1-standard deviation change in ontreatment values were 1.25 (95% confidence interval [CI], 1.07 to 1.47) for LDL-C, 1.31 (95% CI, 1.09 to 1.57) for non-HDL-C, 1.05 (95% CI, 0.91 to 1.21) for TG, and 1.16 (95% CI, 0.98 to 1.37) for HDL-C, after adjusting for potential confounders and lipid parameters mutually. The predictive ability of on-statin LDL-C and non-HDL-C for MACE was prominent in patients at high cardiovascular risk or those with LDL-C ≥70 mg/dL.
Conclusion
On-statin LDL-C and non-HDL-C levels are better predictors of the first cardiovascular event than TG or HDL-C in patients with T2DM.

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Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population–Pronounced Age-Related Disparities: Nationwide Cohort Study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetes & Metabolism Journal.2025; 49(5): 1040. CrossRef
Managing dyslipidemia in chronic kidney disease: a comprehensive overview of evidence and recommendations
Ji Yoon Kim, Suk Min Chung, Nam Hoon Kim
The Korean Journal of Internal Medicine.2025; 40(6): 876. CrossRef

Editorial

Optimal Low-Density Lipoprotein Cholesterol Level for Primary Prevention in Koreans with Type 2 Diabetes Mellitus: Ji Yoon Kim, Nam Hoon Kim; Diabetes Metab J. 2023;47(1):42-44. Published online January 26, 2023; DOI: https://doi.org/10.4093/dmj.2022.0454

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Sensing Biomechanical Alterations in Red Blood Cells of Type 1 Diabetes Patients: Potential Markers for Microvascular Complications
Riccardo Di Santo, Benedetta Niccolini, Alessandro Rizzi, Laura Bertini, Denise Pires Marafon, Maria Vaccaro, Federica Cristallo, Enrico Rosa, Linda Tartaglione, Laura Leo, Marco De Spirito, Gabriele Ciasca, Dario Pitocco
Biosensors.2024; 14(12): 587. CrossRef

Original Article

Metabolic Risk/Epidemiology
Associations between Weight-Adjusted Waist Index and Abdominal Fat and Muscle Mass: Multi-Ethnic Study of Atherosclerosis: Ji Yoon Kim, Jimi Choi, Chantal A. Vella, Michael H. Criqui, Matthew A. Allison, Nam Hoon Kim; Diabetes Metab J. 2022;46(5):747-755. Published online March 30, 2022; DOI: https://doi.org/10.4093/dmj.2021.0294

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Background
The weight-adjusted waist index (WWI) reflected body compositional changes with aging. This study was to investigate the association of WWI with abdominal fat and muscle mass in a diverse race/ethnic population.
Methods
Computed tomography (CT) data from 1,946 participants for abdominal fat and muscle areas from the Multi-Ethnic Study of Atherosclerosis (785 Whites, 252 Asians, 406 African American, and 503 Hispanics) were used. Among them, 595 participants underwent repeated CT. The WWI was calculated as waist circumference (cm) divided by the square root of body weight (kg). The associations of WWI with abdominal fat and muscle measures were examined, and longitudinal changes in abdominal composition measures were compared.
Results
In all race/ethnic groups, WWI was positively correlated with total abdominal fat area (TFA), subcutaneous fat area, and visceral fat area, but negatively correlated with total abdominal muscle area (TMA) and abdominal muscle radiodensity (P<0.001 for all). WWI showed a linear increase with aging regardless of race and there were no significant differences in the WWI distribution between Whites, Asians, and African Americans. In longitudinal analyses, over 38.6 months of follow-up, all abdominal fat measures increased but muscle measures decreased, along with increase in WWI. The more the WWI increased, the more the TFA increased and the more the TMA decreased.
Conclusion
WWI showed positive associations with abdominal fat mass and negative associations with abdominal muscle mass, which likely reflects the abdominal compositional changes with aging in a multi-ethnic population.

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