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Complications
Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study
Han Na Jang, Min Kyong Moon, Bo Kyung Koo
Diabetes Metab J. 2022;46(4):620-629.   Published online February 23, 2022
DOI: https://doi.org/10.4093/dmj.2021.0099
  • 5,005 View
  • 228 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We investigated the prevalence of diabetic retinopathy (DR) in patients with undiagnosed diabetes through a nationwide survey, compared to those with known diabetes.
Methods
Among the participants of the Korean National Health and Nutrition Examination Surveys (KNHANES) from 2017 to 2018, individuals aged ≥40 years with diabetes and fundus exam results were enrolled. Sampling weights were applied to represent the entire Korean population. Newly detected diabetes patients through KNHANES were classified under “undiagnosed diabetes.”
Results
Among a total of 9,108 participants aged ≥40 years, 951 were selected for analysis. Of them, 31.3% (standard error, ±2.0%) were classified under “undiagnosed diabetes.” The prevalence of DR in patients with known and undiagnosed diabetes was 24.5%±2.0% and 10.7%±2.2%, respectively (P<0.001). The DR prevalence increased with rising glycosylated hemoglobin (HbA1c) levels in patients with known and undiagnosed diabetes (P for trend=0.001 in both). Among those with undiagnosed diabetes, the prevalence of DR was 6.9%±2.1%, 8.0%±3.4%, 5.6%±5.7%, 16.7%±9.4%, and 42.6%±14.8% for HbA1c levels of <7.0%, 7.0%–7.9%, 8.0%–8.9%, 9.0%–9.9%, and ≥10.0% respectively. There was no difference in the prevalence of hypertension, dyslipidemia, hypertriglyceridemia, or obesity according to the presence or absence of DR.
Conclusion
About one-third of patients with diabetes were unaware of their diabetes, and 10% of them have already developed DR. Considering increasing the prevalence of DR according to HbA1c level was found in patients with undiagnosed diabetes like those with known diabetes, screening and early detection of diabetes and DR are important.

Citations

Citations to this article as recorded by  
  • Risk factors of peripheral occlusive arterial disease in patients with diabetic retinopathy due to type 2 diabetes
    Milos Maksimovic
    Srpski arhiv za celokupno lekarstvo.2024; 152(1-2): 50.     CrossRef
  • Gene Expression Analysis in T2DM and Its Associated Microvascular Diabetic Complications: Focus on Risk Factor and RAAS Pathway
    Laxmipriya Jena, Prabhsimran Kaur, Tashvinder Singh, Kangan Sharma, Sushil Kotru, Anjana Munshi
    Molecular Neurobiology.2024;[Epub]     CrossRef
  • Trends and Barriers in Diabetic Retinopathy Screening: Korea National Health and Nutritional Examination Survey 2016–2021
    Min Seok Kim, Sang Jun Park, Kwangsic Joo, Se Joon Woo
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Novel Asian-Specific Visceral Adiposity Indices Are Associated with Chronic Kidney Disease in Korean Adults
    Jonghwa Jin, Hyein Woo, Youngeun Jang, Won-Ki Lee, Jung-Guk Kim, In-Kyu Lee, Keun-Gyu Park, Yeon-Kyung Choi
    Diabetes & Metabolism Journal.2023; 47(3): 426.     CrossRef
  • Prevalence of osteosarcopenic obesity and related factors among Iranian older people: Bushehr Elderly Health (BEH) program
    Mozhgan Ahmadinezhad, Mohammad Ali Mansournia, Noushin Fahimfar, Gita Shafiee, Iraj Nabipour, Mahnaz Sanjari, Kazem Khalagi, Mohammad Javad Mansourzadeh, Bagher Larijani, Afshin Ostovar
    Archives of Osteoporosis.2023;[Epub]     CrossRef
Technology/Device
Article image
Development and Validation of a Deep Learning Based Diabetes Prediction System Using a Nationwide Population-Based Cohort
Sang Youl Rhee, Ji Min Sung, Sunhee Kim, In-Jeong Cho, Sang-Eun Lee, Hyuk-Jae Chang
Diabetes Metab J. 2021;45(4):515-525.   Published online February 25, 2021
DOI: https://doi.org/10.4093/dmj.2020.0081
  • 9,600 View
  • 267 Download
  • 8 Web of Science
  • 8 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Previously developed prediction models for type 2 diabetes mellitus (T2DM) have limited performance. We developed a deep learning (DL) based model using a cohort representative of the Korean population.
Methods
This study was conducted on the basis of the National Health Insurance Service-Health Screening (NHIS-HEALS) cohort of Korea. Overall, 335,302 subjects without T2DM at baseline were included. We developed the model based on 80% of the subjects, and verified the power in the remainder. Predictive models for T2DM were constructed using the recurrent neural network long short-term memory (RNN-LSTM) network and the Cox longitudinal summary model. The performance of both models over a 10-year period was compared using a time dependent area under the curve.
Results
During a mean follow-up of 10.4±1.7 years, the mean frequency of periodic health check-ups was 2.9±1.0 per subject. During the observation period, T2DM was newly observed in 8.7% of the subjects. The annual performance of the model created using the RNN-LSTM network was superior to that of the Cox model, and the risk factors for T2DM, derived using the two models were similar; however, certain results differed.
Conclusion
The DL-based T2DM prediction model, constructed using a cohort representative of the population, performs better than the conventional model. After pilot tests, this model will be provided to all Korean national health screening recipients in the future.

Citations

Citations to this article as recorded by  
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    Diabetes & Metabolism Journal.2022; 46(4): 650.     CrossRef
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Review
Complications
Diabetes and Cancer: Cancer Should Be Screened in Routine Diabetes Assessment
Sunghwan Suh, Kwang-Won Kim
Diabetes Metab J. 2019;43(6):733-743.   Published online December 23, 2019
DOI: https://doi.org/10.4093/dmj.2019.0177
  • 9,902 View
  • 280 Download
  • 100 Web of Science
  • 107 Crossref
AbstractAbstract PDFPubReader   

Cancer incidence appears to be increased in both type 1 and type 2 diabetes mellitus (DM). DM represents a risk factor for cancer, particularly hepatocellular, hepatobiliary, pancreas, breast, ovarian, endometrial, and gastrointestinal cancers. In addition, there is evidence showing that DM is associated with increased cancer mortality. Common risk factors such as age, obesity, physical inactivity and smoking may contribute to increased cancer risk in patients with DM. Although the mechanistic process that may link diabetes to cancer is not completely understood yet, biological mechanisms linking DM and cancer are hyperglycemia, hyperinsulinemia, increased bioactivity of insulin-like growth factor 1, oxidative stress, dysregulations of sex hormones, and chronic inflammation. However, cancer screening rate is significantly lower in people with DM than that in people without diabetes. Evidence from previous studies suggests that some medications used to treat DM are associated with either increased or reduced risk of cancer. However, there is no strong evidence supporting the association between the use of anti-hyperglycemic medication and specific cancer. In conclusion, all patients with DM should be undergo recommended age- and sex appropriate cancer screenings to promote primary prevention and early detection. Furthermore, cancer should be screened in routine diabetes assessment.

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  • The impact of diabetes mellitus on levels of sex hormones and their receptors in tumor tissues in female rats with Guerin’s carcinoma
    E. M. Frantsiyants, V. A. Bandovkina, I. V. Kaplieva, E. I. Surikova, Yu. A. Pogorelova, N. D. Cheryarina, I. M. Kotieva, M. I. Morozova, A. I. Shikhlyarova
    Research and Practical Medicine Journal.2022; 9(1): 23.     CrossRef
  • Synergistic association between underweight and type 2 diabetes on the development of laryngeal cancer: a national population-based retrospective cohort study
    Oh. Hyeong Lee, Yong-Moon Park, Seung-Hyun Ko, Kyuna Lee, Yeonji Kim, Kyungdo Han, Jung-Hae Cho
    BMC Cancer.2022;[Epub]     CrossRef
  • Survival Risk Analysis of Small Cell Lung Cancer Patients with Pre-Existing Type 2 Diabetes Mellitus: A Single-Center Retrospective Cohort Study
    Jing Ding, Xudong Li, Jun Ge, Yuanqian Gong, Ya Zhou, Juan Xiao, Qin Yang, Jing Chen, Mian Mao
    Cancer Management and Research.2022; Volume 14: 1313.     CrossRef
  • The High Prevalence of Short-Term Elevation of Tumor Markers Due to Hyperglycemia in Diabetic Patients
    Xi-yu Liu
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 1113.     CrossRef
  • Stationäre Patienten mit der Nebendiagnose Diabetes mellitus: klinische Relevanz
    Christian Jenssen, Cristine Pietsch
    Die Diabetologie.2022; 18(4): 379.     CrossRef
  • Utility of Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio in Evaluating Incident Diabetes Risk
    Guotai Sheng, Dingyang Liu, Maobin Kuang, Yanjia Zhong, Shuhua Zhang, Yang Zou
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 1677.     CrossRef
  • The Association of Dietary Fiber Intake in Three Meals with All-Cause and Disease-Specific Mortality among Adults: The U.S. National Health and Nutrition Examination Survey, 2003–2014
    Jiayue Qi, Jian Gao, Yuntao Zhang, Wanying Hou, Tianshu Han, Changhao Sun
    Nutrients.2022; 14(12): 2521.     CrossRef
  • A Serum Metabolite Classifier for the Early Detection of Type 2 Diabetes Mellitus-Positive Hepatocellular Cancer
    Lin-Lin Cao, Yi Han, Lin Pei, Zhi-Hong Yue, Bo-Yu Liu, Jing-Wen Cui, Mei Jia, Hui Wang
    Metabolites.2022; 12(7): 610.     CrossRef
  • Extra-Glycemic Effects of Anti-Diabetic Medications: Two Birds with One Stone?
    Eun-Jung Rhee
    Endocrinology and Metabolism.2022; 37(3): 415.     CrossRef
  • Improvement in Age at Mortality and Changes in Causes of Death in the Population with Diabetes: An Analysis of Data from the Korean National Health Insurance and Statistical Information Service, 2006 to 2018
    Eugene Han, Sun Ok Song, Hye Soon Kim, Kang Ju Son, Sun Ha Jee, Bong-Soo Cha, Byung-Wan Lee
    Endocrinology and Metabolism.2022; 37(3): 466.     CrossRef
  • Novel insights into the pathogenic impact of diabetes on the gastrointestinal tract
    Piero Portincasa, Leonilde Bonfrate, David Q.‐H. Wang, Gema Frühbeck, Gabriella Garruti, Agostino Di Ciaula
    European Journal of Clinical Investigation.2022;[Epub]     CrossRef
  • Editorial: The relationship between diabetes and cancers and its underlying mechanisms
    Qiang Huo, Jing Wang, Nannan Zhang, Long Xie, Heshan Yu, Tao Li
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Oxidatively Damaged Nucleic Acid: Linking Diabetes and Cancer
    Xiujuan Hong, Yiqiu Hu, Zhijun Yuan, Zhihao Fang, Xiaoxiao Zhang, Ying Yuan, Cheng Guo
    Antioxidants & Redox Signaling.2022; 37(16-18): 1153.     CrossRef
  • Diabetes mellitus and endometrial carcinoma: Risk factors and etiological links
    Ya Wang, Xinling Zeng, Jie Tan, Yi Xu, Cunjian Yi
    Medicine.2022; 101(34): e30299.     CrossRef
  • The Good, the Bad and the New about Uric Acid in Cancer
    Simone Allegrini, Mercedes Garcia-Gil, Rossana Pesi, Marcella Camici, Maria Grazia Tozzi
    Cancers.2022; 14(19): 4959.     CrossRef
  • Family cancer history and smoking habit associated with sarcoma in a Japanese population study
    Yoshihiro Araki, Norio Yamamoto, Yoshikazu Tanzawa, Takahiro Higashi, Aya Kuchiba, Katsuhiro Hayashi, Akihiko Takeuchi, Shinji Miwa, Kentaro Igarashi, Makoto Endo, Eisuke Kobayashi, Hiroyuki Tsuchiya, Akira Kawai
    Scientific Reports.2022;[Epub]     CrossRef
  • Decreased IGF-1 level is associated with restrained amino acid metabolism in NSCLC with diabetes mellitus
    Hehe Lv, Fan Zhang, Can Liang, Xuekui Liu, Yamei Ma, Jiayi Li, Yan Ye, Shanwen Si, Yaran Liu, Hao Heng, Houfa Geng
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Acute Pancreatitis Increases the Risk of Gastrointestinal Cancer in Type 2 Diabetic Patients: A Korean Nationwide Cohort Study
    Jin Ho Choi, Woo Hyun Paik, Dong Kee Jang, Min Kyu Kim, Ji Kon Ryu, Yong-Tae Kim, Kyungdo Han, Sang Hyub Lee
    Cancers.2022; 14(22): 5696.     CrossRef
  • Targets for the prevention of comorbidity of cardiovascular and cancer diseases
    M. N. Mamedov, K. K. Badeinikova, A. K. Karimov
    Russian Journal of Cardiology.2022; 27(11): 5235.     CrossRef
  • Prevalence and potential risk factors of self-reported diabetes among elderly people in China: A national cross-sectional study of 224,142 adults
    Xing Hu, Lingbing Meng, Zhimin Wei, Hongxuan Xu, Jianyi Li, Yingying Li, Na Jia, Hui Li, Xin Qi, Xuezhai Zeng, Qiuxia Zhang, Juan Li, Deping Liu
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Urinary Exosomal Tissue TIMP and Angiopoietin-1 Are Preoperative Novel Biomarkers of Well-Differentiated Thyroid Cancer
    Chih-Yuan Wang, Shyang-Rong Shih, Kuen-Yuan Chen, Pei-Jie Huang
    Biomedicines.2022; 11(1): 24.     CrossRef
  • Acquired and modifiable cardiovascular risk factors in patients treated for cancer
    Gary S. Beasley, Jeffrey A. Towbin
    Journal of Thrombosis and Thrombolysis.2021; 51(4): 846.     CrossRef
  • Diabetes and Cancer: Metabolic Association, Therapeutic Challenges, and the Role of Natural Products
    Wamidh H. Talib, Asma Ismail Mahmod, Sara Feras. Abuarab, Eliza Hasen, Amer A. Munaim, Shatha Khaled Haif, Amani Marwan Ayyash, Samar Khater, Intisar Hadi AL-Yasari, Lina T. Al Kury
    Molecules.2021; 26(8): 2179.     CrossRef
  • Epidemiological link between obesity, type 2 diabetes mellitus and cancer
    Cornelius J Fernandez, Annu Susan George, Nikhila A Subrahmanyan, Joseph M Pappachan
    World Journal of Methodology.2021; 11(3): 23.     CrossRef
  • Evaluation of the Efficacy of the Hospital Glycemic Management System for Patients with Malignant Tumors and Hyperglycemia
    Juan Jiang, Danlan Pu, Renzhi Hu, Mingyang Hu, Qinan Wu
    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2021; Volume 14: 2717.     CrossRef
  • Insulin-Like Growth Factor 1 (IGF-1) Signaling in Glucose Metabolism in Colorectal Cancer
    Aldona Kasprzak
    International Journal of Molecular Sciences.2021; 22(12): 6434.     CrossRef
  • TNBC: Potential Targeting of Multiple Receptors for a Therapeutic Breakthrough, Nanomedicine, and Immunotherapy
    Desh Deepak Singh, Dharmendra Kumar Yadav
    Biomedicines.2021; 9(8): 876.     CrossRef
  • GLP-1 Receptor Agonists: Beyond Their Pancreatic Effects
    Xin Zhao, Minghe Wang, Zhitong Wen, Zhihong Lu, Lijuan Cui, Chao Fu, Huan Xue, Yunfeng Liu, Yi Zhang
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • The Aneugenicity of Ketone Bodies in Colon Epithelial Cells Is Mediated by Microtubule Hyperacetylation and Is Blocked by Resveratrol
    Haruka Sudo, Akira Kubo
    International Journal of Molecular Sciences.2021; 22(17): 9397.     CrossRef
  • EFFECT OF DIABETES MELLITUS ON THE LEVEL OF GROWTH FACTORS IN GUERIN CARCINOMA IN RATS OF BOTH SEXES
    E.M. Frantsiyants, V.A. Bandovkina, I.V. Kaplieva, E.I. Surikova, I.V. Neskubina, L.K. Trepitaki, N.D. Cheryarina, Yu.A. Pogorelova, L.A. Nemashkalova, A.I. Shikhlyarova, I.M. Kotieva, M.I. Morozova
    Ulyanovsk Medico-biological Journal.2021; : 129.     CrossRef
  • Clinical Significance of Screening Differential Metabolites in Ovarian Cancer Tissue and Ascites by LC/MS
    Miao Liu, Yu Liu, Hua Feng, Yixin Jing, Shuang Zhao, Shujia Yang, Nan Zhang, Shi Jin, Yafei Li, Mingjiao Weng, Xinzhu Xue, Fuya Wang, Yongheng Yang, Xiaoming Jin, Dan Kong
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
  • Diabetes mellitus and cancer: a system of insulin-like growth factors
    E. M. Frantsiyants, E. I. Surikova, I. V. Kaplieva, V. A. Bandovkina, I. V. Neskubina, E. A. Sheiko, M. I. Morozova, I. M. Kotieva
    Problems of Endocrinology.2021; 67(5): 34.     CrossRef
  • Diabetes and Cancer: Risk, Challenges, Management and Outcomes
    Rabia K. Shahid, Shahid Ahmed, Duc Le, Sunil Yadav
    Cancers.2021; 13(22): 5735.     CrossRef
  • Obesity, Diabetes, and Increased Cancer Progression
    Dae-Seok Kim, Philipp E. Scherer
    Diabetes & Metabolism Journal.2021; 45(6): 799.     CrossRef
  • Simple Serum Pancreatic Ductal Adenocarcinoma (PDAC) Protein Biomarkers—Is There Anything in Sight?
    Monika Kapszewicz, Ewa Małecka-Wojciesko
    Journal of Clinical Medicine.2021; 10(22): 5463.     CrossRef
  • Chronic non-communicable diseases, risk factors, and quality of life in patients with malignancies of various localizations
    M.N. Mamedov, V.I. Potievskaya, E.K. Saribekyan, O.V. Pikin, D.V. Sidorov, Z.M. Salimov, V.A. Kutsenko, O.M. Drapkina
    Profilakticheskaya meditsina.2021; 24(11): 45.     CrossRef
  • Survival after breast cancer in women with type 2 diabetes using antidiabetic medication and statins: a retrospective cohort study
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    Acta Oncologica.2020; 59(9): 1110.     CrossRef
  • Transcriptional Profiling and Biological Pathway(s) Analysis of Type 2 Diabetes Mellitus in a Pakistani Population
    Zarish Noreen, Christopher A. Loffredo, Attya Bhatti, Jyothirmai J. Simhadri, Gail Nunlee-Bland, Thomas Nnanabu, Peter John, Jahangir S. Khan, Somiranjan Ghosh
    International Journal of Environmental Research and Public Health.2020; 17(16): 5866.     CrossRef
  • Screening Strategy of Pancreatic Cancer in Patients with Diabetes Mellitus
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    Diagnostics.2020; 10(8): 572.     CrossRef
  • Changes in mortality rates and ratios in people with pharmacologically treated type 2 diabetes mellitus between 2001 and 2016 in Hungary
    György Jermendy, Zoltán Kiss, György Rokszin, Ibolya Fábián, István Wittmann, Péter Kempler
    Diabetes Research and Clinical Practice.2020; 163: 108134.     CrossRef
  • Role of αVβ3 in Prostate Cancer: Metastasis Initiator and Important Therapeutic Target


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    OncoTargets and Therapy.2020; Volume 13: 7411.     CrossRef
  • Arterial stiffness is an independent predictor for risk of mortality in patients with type 2 diabetes mellitus: the REBOUND study
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    Cardiovascular Diabetology.2020;[Epub]     CrossRef
  • An Overview of Cancer Prevention: Chemoprevention and Immunoprevention
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    Biomedicine & Pharmacotherapy.2020; 131: 110764.     CrossRef
  • Diabetes mellitus and the risk of ovarian cancer: a systematic review and meta-analysis of cohort and case–control studies
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    BMJ Open.2020; 10(12): e040137.     CrossRef

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