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Original Article
Guideline/Fact Sheet
2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association
Jun Sung Moon, Shinae Kang, Jong Han Choi, Kyung Ae Lee, Joon Ho Moon, Suk Chon, Dae Jung Kim, Hyun Jin Kim, Ji A Seo, Mee Kyoung Kim, Jeong Hyun Lim, Yoon Ju 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, Jaehyun Bae, Eonju Jeon, Ji Min Kim, Seon Mee Kang, Jung Hwan Park, Jae-Seung Yun, Bong-Soo Cha, Min Kyong Moon, Byung-Wan Lee
Diabetes Metab J. 2024;48(4):546-708.   Published online July 26, 2024
DOI: https://doi.org/10.4093/dmj.2024.0249
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  • 375 Download
  • 4 Crossref
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Citations

Citations to this article as recorded by  
  • Adherence to the nutritional recommendations according to diabetes status in Korean adults: a cross-sectional study
    Jong Han Choi, Chen Lulu, Seon-Joo Park, Hae-Jeung Lee
    BMC Public Health.2024;[Epub]     CrossRef
  • 당뇨병 치료의 진화: 관해를 향해가는 혁신적 약물치료와 첨단 관리기기의 결합
    종한 최, 민경 문
    Public Health Weekly Report.2024; 17(44): 1905.     CrossRef
  • The Impact of the Dietary Inflammatory Index, Fasting Blood Glucose, and Smoking Status on the Incidence and Survival of Pancreatic Cancer: A Retrospective Case–Control Study and a Prospective Study
    Ga Hyun Lee, Yeon Hee Kim, Sang Myung Woo, Woo Jin Lee, Sung-Sik Han, Sang-Jae Park, Sherry Price, Penias Tembo, James R. Hébert, Mi Kyung Kim
    Nutrients.2024; 16(22): 3941.     CrossRef
  • Enhancing Large Language Model Reliability: Minimizing Hallucinations with Dual Retrieval-Augmented Generation Based on the Latest Diabetes Guidelines
    Jaedong Lee, Hyosoung Cha, Yul Hwangbo, Wonjoong Cheon
    Journal of Personalized Medicine.2024; 14(12): 1131.     CrossRef
Review
Guideline/Fact Sheet
Article image
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
  • 11,090 View
  • 1,192 Download
  • 33 Web of Science
  • 41 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  
  • Efficacy and safety of a fixed‐dose combination of dapagliflozin and linagliptin (AJU‐A51) in patients with type 2 diabetes mellitus: A multicentre, randomized, double‐blind, parallel‐group, placebo‐controlled phase III study
    Jun Hwa Hong, Myung Jin Kim, Kyung Wan Min, Jong Chul Won, Tae Nyun Kim, Byung‐Wan Lee, Jun Goo Kang, Jae Hyeon Kim, Jung Hwan Park, Bon Jeong Ku, Chang Beom Lee, Sang Yong Kim, Ho Sang Shon, Woo Je Lee, Joong‐Yeol Park
    Diabetes, Obesity and Metabolism.2025; 27(1): 81.     CrossRef
  • Management of Elderly Patients with Chronic Kidney Disease
    Yohan Park, Won Min Hwang
    Yonsei Medical Journal.2025;[Epub]     CrossRef
  • Quality of Life in Women With Gestational Diabetes Mellitus and Treatment Satisfaction Upon Intermittently Scanned Continuous Glucose Monitoring
    Sookyung Won, Hyeon Ji Kim, Jee Yoon Park, Kyung Joon Oh, Sung Hee Choi, Hak Chul Jang, Joon Ho Moon
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • 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; 109(12): e2317.     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
  • Fenofibrate to prevent amputation and reduce vascular complications in patients with diabetes: FENO-PREVENT
    Eu Jeong Ku, Bongseong Kim, Kyungdo Han, Seung-Hwan Lee, Hyuk-Sang Kwon
    Cardiovascular Diabetology.2024;[Epub]     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; 257: 116297.     CrossRef
  • Cardiorenal outcomes and mortality after sodium‐glucose cotransporter‐2 inhibitor initiation in type 2 diabetes patients with percutaneous coronary intervention history
    Jin Hwa Kim, Young Sang Lyu, BongSeong Kim, Mee Kyung Kim, Sang Yong Kim, Ki‐Hyun Baek, Ki‐Ho Song, Kyungdo Han, Hyuk‐Sang Kwon
    Diabetes, Obesity and Metabolism.2024; 26(7): 2567.     CrossRef
  • SGLT2i impact on HCC incidence in patients with fatty liver disease and diabetes: a nation-wide cohort study in South Korea
    Hyo Jung Cho, Eunyoung Lee, Soon Sun Kim, Jae Youn Cheong
    Scientific Reports.2024;[Epub]     CrossRef
  • The importance of diabetes mellitus in dental practice
    Nina Dimitrijević-Jovanović, Hristina Ugrinović, Radomir Mitić, Nevena Kalezić
    Galenika Medical Journal.2024; 3(9): 80.     CrossRef
  • Evaluation of glycemic response of ten local meals commonly consumed from Chad
    Zoufane Guedeungbe, Jean Paul Bayang, Benoît Bargui Koubala
    Journal of Agriculture and Food Research.2024; 17: 101251.     CrossRef
  • Glycemic Control and Oral Health Outcomes in Patients With Diabetes: Insights From a Nationwide Korean Survey
    Song-Yi Yu, Sun-Kyung Lee, Bumhee Yang, Hyun Lee, Hyun Jeong Jeon, Dong-Hwa Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Efficacy and safety of albiglutide, a once-weekly glucagon-like peptide-1 receptor agonist, in patients with type 2 diabetes: A systematic review and meta-analysis
    A.B.M. Kamrul-Hasan, Deep Dutta, Lakshmi Nagendra, Saptarshi Bhattacharya, Rajiv Singla, Sanjay Kalra
    Medicine.2024; 103(25): e38568.     CrossRef
  • Longitudinal Analysis of Diabetes Mellitus Risk: Smoking Status and Smoking Cessation
    Da-Eun Sung, Seung-Jae Lee, Mi-Yeon Lee, Eun-Jung Rhee, Ki-Chul Sung
    Journal of Clinical Medicine.2024; 13(13): 3927.     CrossRef
  • Current type 2 diabetes guidelines: Individualized treatment and how to make the most of metformin
    Juliana C. N. Chan, Aimin Yang, Natural Chu, Elaine Chow
    Diabetes, Obesity and Metabolism.2024; 26(S3): 55.     CrossRef
  • Comprehensive management of polypharmacy in older patients with diabetes
    Kang Seo Park, Hea Min Yu
    Journal of the Korean Medical Association.2024; 67(7): 449.     CrossRef
  • The Key Role of Nutritional Intervention in Delaying Disease Progression and the Therapeutic Management of Diabetic Kidney Disease—A Challenge for Physicians and Patients
    Ileana Peride, Miruna Anastasiu, Silvia Alexandra Serban, Mirela Tiglis, Razvan Ene, Ana-Maria Nechita, Tiberiu Paul Neagu, Ionel Alexandru Checherita, Andrei Niculae
    Journal of Personalized Medicine.2024; 14(8): 778.     CrossRef
  • Efficacy and Safety of Pioglitazone Add-on in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Metformin and Dapagliflozin: A Multicenter, Randomized, Double-blind, and Placebo-controlled Study
    Yun Kyung Cho, Kyung-Soo Kim, Byung-Wan Lee, Jun Hwa Hong, Jae Myung Yu, Soo Lim, Ye An Kim, Chang Beom Lee, Sang Soo Kim, Soo Heon Kwak, Woo Je Lee
    Clinical Therapeutics.2024; 46(9): 662.     CrossRef
  • Islet transplantation in Korea
    Joonyub Lee, Kun‐Ho Yoon
    Journal of Diabetes Investigation.2024; 15(9): 1165.     CrossRef
  • Effect of gout and diabetic kidney disease on renal cancer development in Korea
    Seung Min Chung, Inha Jung, Da Young Lee, So Young Park, Ji Hee Yu, Jun Sung Moon, Ji A Seo, Kyungdo Han, Nan Hee Kim
    Clinical Kidney Journal.2024;[Epub]     CrossRef
  • Cardiovascular autonomic neuropathy and the risk of diabetic kidney disease
    Injeong Cho, Seohyun Lim, Minjae Kwon, Seung Min Chung, Jun Sung Moon, Ji Sung Yoon, Kyu Chang Won
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Educational Needs and Priorities of People with Diabetes and Healthcare Providers in South Korea: A Mixed-Methods Study
    Shinae Seo, Chun-Ja Kim, Hee Sun Kang, Elizabeth A. Schlenk
    Journal of Transcultural Nursing.2024;[Epub]     CrossRef
  • Changes in serum uteroglobin level in type 2 diabetes mellitus patients
    Joung Youl Lim, Sang-Hyeon Ju, Ji Min Kim, Hyon-Seung Yi, Ju Hee Lee, Hyun Jin Kim, Bon Jeong Ku, Kyong Hye Joung
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • 1-Hour Postload Glucose: Early Screening for High Risk of Type 2 Diabetes in Koreans With Normal Fasting Glucose
    Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Dongwon Yi, Joo Yeon Kim, Su Hyun Kim, Dong Hee Kim, Dasol Kang, Sujin Park, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim, Mi Sook Yun, Yang Ho Kang
    The Journal of Clinical Endocrinology & Metabolism.2024;[Epub]     CrossRef
  • Sodium-glucose cotransporter 2 inhibitors in cardiocerebrovascular disease
    Jin Joo Park
    Cardiovascular Prevention and Pharmacotherapy.2024; 6(4): 103.     CrossRef
  • Systematic review of guideline recommendations for older and frail adults with type 2 diabetes mellitus
    Jennifer Bolt, Valeria Carvalho, Kristine Lin, Sung Ju Lee, Colleen Inglis
    Age and Ageing.2024;[Epub]     CrossRef
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    Kyoung Hwa Ha, Soyoung Shin, EunJi Na, Dae Jung Kim
    Journal of Diabetes Investigation.2024;[Epub]     CrossRef
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    Seongju Kim, Dong Jun Kim, Hooyeon Lee, Dong Keon Yon
    PLOS ONE.2024; 19(11): e0313988.     CrossRef
  • Association of Uterine Leiomyoma with Type 2 Diabetes Mellitus in Young Women: A Population-Based Cohort Study
    Ji-Hee Sung, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
    Diabetes & Metabolism Journal.2024; 48(6): 1105.     CrossRef
  • Combined impact of prediabetes and hepatic steatosis on cardiometabolic outcomes in young adults
    Wonsuk Choi, Minae Park, Sojeong Park, Ji Yong Park, A Ram Hong, Jee Hee Yoon, Kyoung Hwa Ha, Dae Jung Kim, Hee Kyung Kim, Ho-Cheol Kang
    Cardiovascular Diabetology.2024;[Epub]     CrossRef
  • Short‐term efficacy and safety of metformin in individuals with type 2 diabetes and mild hepatic impairment: A propensity score‐matched real‐world study
    Seunghwan Baek, Jongseok Park, Jae‐Yong Chung, Soo Heon Kwak, Seonghae Yoon
    Diabetes, Obesity and Metabolism.2024;[Epub]     CrossRef
  • Management of Dyslipidemia in Patients with Diabetes Mellitus
    Kyung Ae Lee
    The Journal of Korean Diabetes.2023; 24(3): 111.     CrossRef
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    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
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    Sung-Soo Kim, Hun-Sung Kim
    Journal of Personalized Medicine.2023; 14(1): 42.     CrossRef
Original Article
Drug Regimen
Article image
Efficacy and Safety of Enavogliflozin versus Dapagliflozin as Add-on to Metformin in Patients with Type 2 Diabetes Mellitus: A 24-Week, Double-Blind, Randomized Trial
Kyung Ah Han, Yong Hyun Kim, Doo Man Kim, Byung Wan Lee, Suk Chon, Tae Seo Sohn, In Kyung Jeong, Eun-Gyoung Hong, Jang Won Son, Jae Jin Nah, Hwa Rang Song, Seong In Cho, Seung-Ah Cho, Kun Ho Yoon
Diabetes Metab J. 2023;47(6):796-807.   Published online February 9, 2023
DOI: https://doi.org/10.4093/dmj.2022.0315
  • 42,552 View
  • 678 Download
  • 7 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Enavogliflozin is a novel sodium-glucose cotransporter-2 inhibitor currently under clinical development. This study evaluated the efficacy and safety of enavogliflozin as an add-on to metformin in Korean patients with type 2 diabetes mellitus (T2DM) against dapagliflozin.
Methods
In this multicenter, double-blind, randomized, phase 3 study, 200 patients were randomized to receive enavogliflozin 0.3 mg/day (n=101) or dapagliflozin 10 mg/day (n=99) in addition to ongoing metformin therapy for 24 weeks. The primary objective of the study was to prove the non-inferiority of enavogliflozin to dapagliflozin in glycosylated hemoglobin (HbA1c) change at week 24 (non-inferiority margin of 0.35%) (Clinical trial registration number: NCT04634500).
Results
Adjusted mean change of HbA1c at week 24 was –0.80% with enavogliflozin and –0.75% with dapagliflozin (difference, –0.04%; 95% confidence interval, –0.21% to 0.12%). Percentages of patients achieving HbA1c <7.0% were 61% and 62%, respectively. Adjusted mean change of fasting plasma glucose at week 24 was –32.53 and –29.14 mg/dL. An increase in urine glucose-creatinine ratio (60.48 vs. 44.94, P<0.0001) and decrease in homeostasis model assessment of insulin resistance (–1.85 vs. –1.31, P=0.0041) were significantly greater with enavogliflozin than dapagliflozin at week 24. Beneficial effects of enavogliflozin on body weight (–3.77 kg vs. –3.58 kg) and blood pressure (systolic/diastolic, –5.93/–5.41 mm Hg vs. –6.57/–4.26 mm Hg) were comparable with those of dapagliflozin, and both drugs were safe and well-tolerated.
Conclusion
Enavogliflozin added to metformin significantly improved glycemic control in patients with T2DM and was non-inferior to dapagliflozin 10 mg, suggesting enavogliflozin as a viable treatment option for patients with inadequate glycemic control on metformin alone.

Citations

Citations to this article as recorded by  
  • Efficacy and safety of enavogliflozin vs. dapagliflozin as add-on therapy in patients with type 2 diabetes mellitus based on renal function: a pooled analysis of two randomized controlled trials
    Young Sang Lyu, Sangmo Hong, Si Eun Lee, Bo Young Cho, Cheol-Young Park
    Cardiovascular Diabetology.2024;[Epub]     CrossRef
  • A 52‐week efficacy and safety study of enavogliflozin versus dapagliflozin as an add‐on to metformin in patients with type 2 diabetes mellitus: ENHANCE‐M extension study
    Tae Seo Sohn, Kyung‐Ah Han, Yonghyun Kim, Byung‐Wan Lee, Suk Chon, In‐Kyung Jeong, Eun‐Gyoung Hong, Jang Won Son, JaeJin Na, Jae Min Cho, Seong In Cho, Wan Huh, Kun‐Ho Yoon
    Diabetes, Obesity and Metabolism.2024; 26(6): 2248.     CrossRef
  • The effect of renal function on the pharmacokinetics and pharmacodynamics of enavogliflozin, a potent and selective sodium‐glucose cotransporter‐2 inhibitor, in type 2 diabetes
    Sae Im Jeong, Mu Seong Ban, Jun‐Gi Hwang, Min‐Kyu Park, Soo Lim, Sejoong Kim, Soon Kil Kwon, Yoonjin Kim, Jae Min Cho, Jae Jin Na, Wan Huh, Jae‐Yong Chung
    Diabetes, Obesity and Metabolism.2024; 26(7): 2588.     CrossRef
  • Long‐term efficacy and safety of enavogliflozin in Korean people with type 2 diabetes: A 52‐week extension of a Phase 3 randomized controlled trial
    Soo Heon Kwak, Kyung Ah Han, Eun Sook Kim, Sung Hee Choi, Jong Chul Won, Jae Myung Yu, Seungjoon Oh, Hye Jin Yoo, Chong Hwa Kim, Kyung‐Soo Kim, SungWan Chun, Yong Hyun Kim, Seung Ah Cho, Da Hye Kim, Kyong Soo Park
    Diabetes, Obesity and Metabolism.2024; 26(10): 4203.     CrossRef
  • Role of novel sodium glucose co-transporter-2 inhibitor enavogliflozin in type-2 diabetes: A systematic review and meta-analysis
    Deep Dutta, B.G. Harish, Beatrice Anne, Lakshmi Nagendra
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2023; 17(8): 102816.     CrossRef
  • Characteristics of the Latest Therapeutic Agent for Diabetes
    Nuri Yun
    The Journal of Korean Diabetes.2023; 24(3): 148.     CrossRef
  • Prospects of using sodium-glucose co-transporter-2 (SGLT-2) inhibitors in patients with metabolic-associated fatty liver disease (MAFLD)
    Iryna Kostitska, Nadia Protas, Liliia Petrovska
    Diabetes Obesity Metabolic Syndrome.2023; (5): 8.     CrossRef
  • Navigating the Future of Diabetes Treatment with New Drugs: Focusing on the Possibilities and Prospects of Enavogliflozin
    Sang Youl Rhee
    Diabetes & Metabolism Journal.2023; 47(6): 769.     CrossRef
Review
Guideline/Fact Sheet
Article image
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
  • 5,965 View
  • 297 Download
  • 7 Web of Science
  • 12 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
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    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
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    Min Jin Lee, Ji Hyun Bae, Ah Reum Khang, Dongwon Yi, Mi Sook Yun, Yang Ho Kang
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    Yu-xiang Xu, Shan-shan Wang, Yu-hui Wan, Pu-yu Su, Fang-biao Tao, Ying Sun
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    Xiaoyan Yi, Yongliang Pan, Huan Peng, Mengru Ren, Qin Jia, Bing Wang
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    Kyoung Hwa Ha, Dae Jung Kim
    Endocrinology and Metabolism.2024; 39(5): 669.     CrossRef
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    Myoung-Lyun Heo
    Journal of Korean Biological Nursing Science.2024; 26(4): 300.     CrossRef
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    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
Original Article
Drug/Regimen
Article image
Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease
Jong Ha Baek, Ye Seul Yang, Seung-Hyun Ko, Kyung Do Han, Jae Hyeon Kim, Min Kyong Moon, Jong Suk Park, Byung-Wan Lee, Tae Jung Oh, Suk Chon, Jong Han Choi, Kyu Yeon Hur, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2022;46(5):701-712.   Published online June 3, 2022
DOI: https://doi.org/10.4093/dmj.2022.0002
  • 6,169 View
  • 352 Download
  • 13 Web of Science
  • 15 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To evaluate prescription trends and clinical factors of the sodium-glucose cotransporter 2 inhibitors (SGLT2i) use according to the presence of atherosclerotic cardiovascular disease (ASCVD) or heart failure (HF) in Korean patients with type 2 diabetes mellitus (T2DM).
Methods
Prescription patterns of SGLT2i use between 2015 and 2019 were determined using the Korean National Health Insurance Service database of claims.
Results
Of all patients with T2DM (n=4,736,493), the annual prescription rate of SGLT2i increased every year in patients with ASCVD (from 2.2% to 10.7%) or HF (from 2.0% to 11.1%). After the first hospitalization for ASCVD (n=518,572), 13.7% (n=71,259) of patients initiated SGLT2i with a median of 10.6 months. After hospitalization for HF (n=372,853), 11.2% (n=41,717) of patients initiated SGLT2i after a median of 8.8 months. In multivariate regression for hospitalization, older age (per 10 years, odds ratio [OR], 0.57; 95% confidence interval [CI], 0.56 to 0.57), lower household income (OR, 0.93; 95% CI, 0.92 to 0.95), rural residents (OR, 0.95; 95% CI, 0.93 to 0.97), and dipeptidyl peptidase-4 inhibitor (DPP-4i) users (OR, 0.82; 95% CI, 0.81 to 0.84) were associated with lesser initiation of SGLT2i in ASCVD. Additionally, female gender (OR, 0.97; 95% CI, 0.95 to 0.99) was associated with lesser initiation of SGLT2i in HF.
Conclusion
The prescription rate of SGLT2i increased gradually up to 2019 but was suboptimal in patients with ASCVD or HF. After the first hospitalization for ASCVD or HF, older age, female gender, low household income, rural residents, and DPP-4i users were less likely to initiate SGLT2i.

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Reviews
Guideline/Fact Sheet
Article image
Comprehensive Understanding for Application in Korean Patients with Type 2 Diabetes Mellitus of the Consensus Statement on Carbohydrate-Restricted Diets by Korean Diabetes Association, Korean Society for the Study of Obesity, and Korean Society of Hypertension
Jong Han Choi, Jee-Hyun Kang, Suk Chon
Diabetes Metab J. 2022;46(3):377-390.   Published online May 25, 2022
DOI: https://doi.org/10.4093/dmj.2022.0051
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AbstractAbstract PDFPubReader   ePub   
The Joint Committee of the Korean Diabetes Association, the Korean Society for the Study of Obesity, and the Korean Society of Hypertension announced a consensus statement on carbohydrate-restricted diets and intermittent fasting, representing an emerging and popular dietary pattern. In this statement, we recommend moderately-low-carbohydrate or low-carbohydrate diets, not a very-low-carbohydrate diet, for patients with type 2 diabetes mellitus. These diets can be considered a dietary regimen to improve glycemic control and reduce body weight in adults with type 2 diabetes mellitus. This review provides the detailed results of a meta-analysis and systematic literature review on the potential harms and benefits of carbohydrate-restricted diets in patients with diabetes. We expect that this review will help experts and patients by fostering an in-depth understanding and appropriate application of carbohydrate-restricted diets in the comprehensive management of diabetes.

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    Do Gyeong Lee, In Gyeong Kang, Tae Seok Kim, Yun Ahn, Sang Yun Lee, Hye Jin Ahn, Yoo Kyoung Park
    Nutrition.2024; 118: 112287.     CrossRef
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    Suk Chon
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Guideline/Fact Sheet
Article image
Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension Management: Consensus Statement of the Korean Society for the Study of Obesity, Korean Diabetes Association, and Korean Society of Hypertension
Jong Han Choi, Yoon Jeong Cho, Hyun-Jin Kim, Seung-Hyun Ko, Suk Chon, Jee-Hyun Kang, Kyoung-Kon Kim, Eun Mi Kim, Hyun Jung Kim, Kee-Ho Song, Ga Eun Nam, Kwang Il Kim, Committee of Clinical Practice Guidelines, Korean Society for the Study of Obesity (KSSO), Committee of Clinical Practice Guidelines and Committee of Food and Nutrition, Korean Diabetes Association (KDA), Policy Committee of Korean Society of Hypertension (KSH), Policy Development Committee of National Academy of Medicine of Korea (NAMOK)
Diabetes Metab J. 2022;46(3):355-376.   Published online May 25, 2022
DOI: https://doi.org/10.4093/dmj.2022.0038
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  • 678 Download
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Carbohydrate-restricted diets and intermittent fasting (IF) have been rapidly gaining interest among the general population and patients with cardiometabolic disease, such as overweight or obesity, diabetes, and hypertension. However, there are limited expert recommendations for these dietary regimens. This study aimed to evaluate the level of scientific evidence on the benefits and harms of carbohydrate-restricted diets and IF to make responsible recommendations. A meta-analysis and systematic literature review of 66 articles on 50 randomized controlled trials (RCTs) of carbohydrate-restricted diets and 10 articles on eight RCTs of IF was performed. Based on the analysis, the following recommendations are suggested. In adults with overweight or obesity, a moderately-low carbohydrate or low carbohydrate diet (mLCD) can be considered as a dietary regimen for weight reduction. In adults with type 2 diabetes mellitus, mLCD can be considered as a dietary regimen for improving glycemic control and reducing body weight. In contrast, a very-low carbohydrate diet (VLCD) and IF are recommended against in patients with diabetes. Furthermore, no recommendations are suggested for VLCD and IF in adults with overweight or obesity, and carbohydrate-restricted diets and IF in patients with hypertension. Here, we describe the results of our analysis and the evidence for these recommendations.

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    Mileni Vanti Beretta, Cíntia Aparecida Oliveira Flores, Gabriella Fontes Colameo, Luana Weissheimer Echabe, Fernanda Michielin Busnello
    Nutrition Reviews.2024;[Epub]     CrossRef
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    Suk Chon
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    Jong Han Choi, Jee-Hyun Kang, Suk Chon
    Diabetes & Metabolism Journal.2022; 46(3): 377.     CrossRef
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Technology/Device
Article image
Assessment of Insulin Secretion and Insulin Resistance in Human
So Young Park, Jean-François Gautier, Suk Chon
Diabetes Metab J. 2021;45(5):641-654.   Published online September 30, 2021
DOI: https://doi.org/10.4093/dmj.2021.0220
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Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReader   ePub   
The impaired insulin secretion and increased insulin resistance (or decreased insulin sensitivity) play a major role in the pathogenesis of all types of diabetes mellitus (DM). It is very important to assess the pancreatic β-cell function and insulin resistance/ sensitivity to determine the type of DM and to plan an optimal management and prevention strategy for DM. So far, various methods and indices have been developed to assess the β-cell function and insulin resistance/sensitivity based on static, dynamic test and calculation of their results. In fact, since the metabolism of glucose and insulin is made through a complex process related with various stimuli in several tissues, it is difficult to fully reflect the real physiology. In order to solve the theoretical and practical difficulties, research on new index is still in progress. Also, it is important to select the appropriate method and index for the purpose of use and clinical situation. This review summarized a variety of traditional methods and indices to evaluate pancreatic β-cell function and insulin resistance/sensitivity and introduced novel indices.

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Guideline/Fact Sheet
Article image
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
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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.

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Clinical Care/Education
Article image
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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Original Article
Clinical Diabetes and Therapeutics
Hospital-Based Korean Diabetes Prevention Study: A Prospective, Multi-Center, Randomized, Open-Label Controlled Study
Sang Youl Rhee, Suk Chon, Kyu Jeung Ahn, Jeong-Taek Woo
Diabetes Metab J. 2019;43(1):49-58.   Published online November 2, 2018
DOI: https://doi.org/10.4093/dmj.2018.0033
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AbstractAbstract PDFPubReader   
Background

The prevalence of diabetes mellitus (DM) continues to increase, and the disease burden is the highest of any medical condition in Korea. However, large-scale clinical studies have not yet conducted to establish the basis for diabetes prevention in Korea.

Methods

The hospital-based Korean Diabetes Prevention Study (H-KDPS) is a prospective, multi-center, randomized, open-label controlled study conducted at university hospitals for the purpose of gathering data to help in efforts to prevent type 2 DM. Ten university hospitals are participating, and 744 subjects will be recruited. The subjects are randomly assigned to the standard care group, lifestyle modification group, or metformin group, and their clinical course will be observed for 36 months.

Results

All intervention methodologies were developed, validated, and approved by Korean Diabetes Association (KDA) multi-disciplinary team members. The standard control group will engage in individual education based on the current KDA guidelines, and the lifestyle modification group will participate in a professionally guided healthcare intervention aiming for ≥5% weight loss. The metformin group will begin dosing at 250 mg/day, increasing to a maximum of 1,000 mg/day. The primary endpoint of this study is the cumulative incidence of DM during the 3 years after randomization.

Conclusion

The H-KDPS study is the first large-scale clinical study to establish evidence-based interventions for the prevention of type 2 DM in Koreans. The evidence gathered by this study will be useful for enhancing the health of Koreans and improving the stability of the Korean healthcare system (Trial registration: CRIS KCT0002260, NCT02981121).

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Response
Response: Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus (Diabetes Metab J 2018;42:285-95)
So Young Park, Suk Chon
Diabetes Metab J. 2018;42(5):449-450.   Published online October 22, 2018
DOI: https://doi.org/10.4093/dmj.2018.0206
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PDFPubReader   

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Original Articles
Clinical Diabetes and Therapeutics
Cardio-Ankle Vascular Index as a Surrogate Marker of Early Atherosclerotic Cardiovascular Disease in Koreans with Type 2 Diabetes Mellitus
So Young Park, Sang Ook Chin, Sang Youl Rhee, Seungjoon Oh, Jeong-Taek Woo, Sung Woon Kim, Suk Chon
Diabetes Metab J. 2018;42(4):285-295.   Published online July 27, 2018
DOI: https://doi.org/10.4093/dmj.2017.0080
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  • 20 Web of Science
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AbstractAbstract PDFPubReader   
Background

Carotid artery intima medial thickness (IMT), brachial-ankle pulse wave velocity (baPWV), and ankle-brachial index (ABI) are commonly used surrogate markers of subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). The cardio-ankle vascular index (CAVI) is a complement to the baPWV, which is affected by blood pressure. However, it is unclear which marker is the most sensitive predictor of atherosclerotic cardiovascular disease (ASCVD).

Methods

This was a retrospective non-interventional study that enrolled 219 patients with T2DM. The correlations among IMT, ABI, and CAVI as well as the relationship of these tests to the 10-year ASCVD risk were also analyzed.

Results

Among the 219 patients, 39 (17.8%) had ASCVD. In the non-ASCVD group, CAVI correlated significantly with IMT after adjusting for confounding variables, but ABI was not associated with CAVI or IMT. The analyses after dividing the non-ASCVD group into three subgroups according to the CAVI score (<8, ≥8 and <9, and ≥9) demonstrated the significant increase in the mean IMT, 10-year ASCVD risk and number of metabolic syndrome risk factors, and decrease in the mean ABI in the high-CAVI group. A high CAVI was an independent risk factor in the non-ASCVD group for both a high 10-year ASCVD risk (≥7.5%; odds ratio [OR], 2.42; P<0.001) and atherosclerosis (mean IMT ≥1 mm; OR, 1.53; P=0.007).

Conclusion

In Korean patients with T2DM without ASCVD, CAVI was the most sensitive of several surrogate markers for the detection of subclinical atherosclerosis.

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Clinical Care/Education
Impact of Socioeconomic Status on Health Behaviors, Metabolic Control, and Chronic Complications in Type 2 Diabetes Mellitus
So Hun Kim, Seung Youn Lee, Chei Won Kim, Young Ju Suh, Seongbin Hong, Seong Hee Ahn, Da Hae Seo, Moon-Suk Nam, Suk Chon, Jeong-Taek Woo, Sei Hyun Baik, Yongsoo Park, Kwan Woo Lee, Young Seol Kim
Diabetes Metab J. 2018;42(5):380-393.   Published online June 29, 2018
DOI: https://doi.org/10.4093/dmj.2017.0102
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

The aim of the study was to assess the impact of socioeconomic status (SES) on health behaviors, metabolic control, and chronic complications in people with type 2 diabetes mellitus (T2DM) from South Korea, a country with universal health insurance coverage and that has experienced rapid economic and social transition.

Methods

A total of 3,294 Korean men and women with T2DM aged 30 to 65 years, participating in the Korean National Diabetes Program (KNDP) cohort who reported their SES and had baseline clinical evaluation were included in the current cross-sectional analysis. SES included the level of education and monthly household income.

Results

Lower education level and lower income level were closely related, and both were associated with older age in men and women. Women and men with lower income and education level had higher carbohydrate and lower fat intake. After adjustment for possible confounding factors, higher education in men significantly lowered the odds of having uncontrolled hyperglycemia (glycosylated hemoglobin ≥7.5%) (odds ratio [OR], 0.63; 95% confidence interval [CI], 0.43 to 0.91 for highest education; Ptrend=0.048), while higher household income in men significantly lowered the odds of having diabetic retinopathy (OR, 0.59; 95% CI, 0.37 to 0.95 for highest income level; Ptrend=0.048). In women, lower income was associated with a higher stress level.

Conclusion

Men with lower SES had higher odds of having diabetic retinopathy and uncontrolled hyperglycemia, showing the need to improve care targeted to this population.

Citations

Citations to this article as recorded by  
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Obesity and Metabolic Syndrome
Air Pollution Has a Significant Negative Impact on Intentional Efforts to Lose Weight: A Global Scale Analysis
Morena Ustulin, So Young Park, Sang Ouk Chin, Suk Chon, Jeong-taek Woo, Sang Youl Rhee
Diabetes Metab J. 2018;42(4):320-329.   Published online April 24, 2018
DOI: https://doi.org/10.4093/dmj.2017.0104
  • 5,357 View
  • 48 Download
  • 6 Web of Science
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AbstractAbstract PDFPubReader   
Background

Air pollution causes many diseases and deaths. It is important to see how air pollution affects obesity, which is common worldwide. Therefore, we analyzed data from a smartphone application for intentional weight loss, and then we validated them.

Methods

Our analysis was structured in two parts. We analyzed data from a cohort registered to a smartphone application in 10 large cities of the world and matched it with the annual pollution values. We validated these results using daily pollution data in United States and matching them with user information. Body mass index (BMI) variation between final and initial login time was considered as outcome in the first part, and daily BMI in the validation. We analyzed: daily calories intake, daily weight, daily physical activity, geographical coordinates, seasons, age, gender. Weather Underground application programming interface provided daily climatic values. Annual and daily values of particulate matter PM10 and PM2.5 were extracted. In the first part of the analysis, we used 2,608 users and then 995 users located in United States.

Results

Air pollution was highest in Seoul and lowest in Detroit. Users decreased BMI by 2.14 kg/m2 in average (95% confidence interval, −2.26 to −2.04). From a multilevel model, PM10 (β=0.04, P=0.002) and PM2.5 (β=0.08, P<0.001) had a significant negative effect on weight loss when collected per year. The results were confirmed with the validation (βAQI*time=1.5×10–5; P<0.001) by mixed effects model.

Conclusion

This is the first study that shows how air pollution affects intentional weight loss applied on wider area of the world.

Citations

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