INTRODUCTION

Diabetes is an important chronic disease causing economic and social burden around the world [1]. The prevalence of type 2 diabetes has substantially increased and is likely to continue to rise, particularly in developing areas including Asia [2].

In Korea, numerous studies on the prevalence, clinical characteristics and economic burden of diabetes has been performed across the past 40 years [3-7], which has recently extended to the evaluation of genomic features in diabetes. The prevalence of diabetes has increased 6- to 7-fold from 1.5% to 9.9%. Many well-designed population-based cohort studies, medical insurance data study, and reports on specific groups of patients, such as old age and gestational period, have been performed. Nonetheless, a nationwide study of diabetes including all age group is not yet common. Eight years ago, the Korean Diabetes Association (KDA) organized a Committee working on the epidemiology of diabetes mellitus to construct nationwide data about diabetes and its managements in Korea. In 2006, the Committee formed a collaborative agreement with Health Insurance Review & Assessment Service (HIRA), which is one of the several government agency collecting national health insurance data: since then, the name of the joint task force changed to Task Force Team for Basic Statistical Study of Korean Diabetes Mellitus (KDA-TFT for BSS) in 2006.

The strategies of KDA-TFT for BSS were to evaluate current status of diabetes and its managements, to establish a standard care and quality standard, to demonstrate the effect of systematic management about diabetes, and to develop a standard model of chronic disease management. This joint report consists of 1) the validity of health insurance data, 2) the prevalence, incidence, and clinical characteristics of diabetes, 3) complications and diabetes management, and 4) the health outcomes, use of healthcare service, and the cost of healthcare. We endeavored to obtain a comprehensive picture of diabetes from the national data on Korea [8-14].

VALIDITY OF HEALTH INSURANCE DATA

We constructed the profiles of diabetic patients (Fig. 1). First, we analyzed an approximately 250 million medical insurance claim database which has submitted at least once per year to HIRA with diabetes as a primary, secondary, or tertiary diagnostic codes in 2003 (ICD-10 code: E10 to E14). Diabetes was defined as those who have been prescribed diabetes medications between the year 2001 and 2003 or those who have fulfilled the diabetes diagnostic criteria (fasting blood glucose ≥126 or ≥200 mg/dL at a random or 2-hour postprandial blood glucose) on the medical record or those who were determined to be diabetic by physician. Using this database, we constructed a patient-hospital profile encompassing 3,676,164 cases and then transformed it to a patient profile consisting of 2,412,082 observations. The size of the total diabetic population was estimated by weighting the sample survey results. Second, we randomly selected 3,902 subjects out of 2,503,754 subjects with claims with diagnosis of diabetes between January 2003 and December 2003 by using a 2-staged cluster sampling method. Based on the evaluation of sampling design for estimating an epidemiologic volume of diabetes, we chose a target sample number of 4,000. Stratification was made into tertiary hospital:general hospital:hospital:clinic (5:10:10:75) and further into district, city, and county. It was identified that a two-stage cluster sampling with the first stage (random sampling of hospitals within a strata) and the second stage (random sampling of patients in the selected hospital) was accurate and efficient. Detailed sampling method was described in previous study [11].

A field survey with review of medical records and telephone survey was conducted with standardized record forms developed by KDA-TFT for BSS. Finally, 1,088,564 patients with diagnosis of diabetes or records of diabetes drug prescription in 2002 aged 20 to 79 years old who survived until the end of year 2004 were included (1st nationwide survey).

The diagnosis validity was 87.2% (95% confidence interval [CI], 83.8% to 90.7%) for admission episodes and 72.3% (95% CI, 67.4% to 77.2%) for outpatient cases. In the analysis of the medical records of 3,902 patients sampled with the 2-stage cluster sampling from 2,412,082 patients for whom more than one claim was filed with diabetes, 62.7% (95% CI, 53.3% to 71.2%) was identified as diabetic by the diabetes patient eligibility criteria.

The health insurance data from HIRA is considered slightly less accurate than other research data in terms of substantiality or reliability. However, this is the only data including the entire national population. Such large-size population makes it the best tool available in predicting public health trends.

PREVALENCE AND INCIDENCE

The prevalence of diabetes in the 2003 population was estimated to be 5.92% (n=2,860,402) of the total national population, with the proportion of 5.33% and 6.52% in men and women, respectively. The prevalence was 1.22 times higher in women. In the age group of 20 to 79 years, the prevalence was estimated at 7.7% (n=2,694,220). The present results are similar to other reports [5-7]. If the current trend in growth continues, the number of diabetic patients is likely to soar up to 3.51 million by the year 2010 (7.08% of the estimated total population), 4.55 million (8.97%) by 2020, and 5.45 million (10.85%) by 2030 (Figs. 2, 3). According to the International Diabetes Federation report, Korea ranked 21st among the 30 Organisation for Economic Co-operation and Development (OECD) member countries in terms of the adult (aged 20 to 79) diabetes prevalence. In our TFT results, diabetes prevalence in Korea is estimated to be ranked between 11th and 12th. If the growth rate continues at the current rate, however, Korea may have the highest prevalence of diabetes among the OECD countries by the year 2030.

The incidence of diabetes (in the 2003 population) was estimated to be 0.57% (n=274,767) of the total population: 0.53% in men and 0.61% in women, respectively. The incidence was 1.16 times higher in women. In the age group of 20 to 79 years, the estimated incidence was 0.76% (n=262,735): 0.73% in men and 0.78% in women, respectively. It is estimated that the diabetic population size would rapidly increase by 10% each year in the future.

CLINICAL CHARACTERISTICS OF DIABETIC PATIENTS

To evaluate the clinical characteristics of diabetic patients, we used the results from the 1st nationwide survey. Patterns and correlations of healthcare use for 2 years (year 2003 and 2004) and outcomes (hospitalization, death, and medical cost) for the following year (2005) were analyzed. Outpatient visit continuance was defined as more than one visit per quarter (3 months) throughout the analysis period with diabetes as principal or secondary diagnosis. Income level was divided into five groups (20 percentile interval) by health insurance premium grades and actual premium amounts. Multivariate analysis was performed with adjustment for gender, age, premium level, residential location, the first year of diagnosis, comorbidities, previous year hospitalization, main healthcare institution of use, prescription continuance, number of institutions visited for outpatient care, and outpatient visit continuance during the previous year.

Our report shows that lower income level is associated with higher likelihood of hospitalization or death. They are also less likely to receive continuous outpatient care. The results show that a comprehensive healthcare service is necessary for low income patients. The 34.6% of the diabetic patients in this analysis had a family history (response rate, 62.7%). Body mass index (BMI) was used as a measurement of obesity. BMI <18.5 kg/m² was measured in 3.4% of subjects, 18.5 to 24.9 kg/m² in 57.2%, 25.0 to 29.9 kg/m² in 34.2%, and ≥30 kg/m² in 5.3%. Women had significantly higher BMI than men (24.7 kg/m² vs. 24.2 kg/m², P<0.05). The results suggest that 39.5% of diabetics in Korea are obese (BMI≥25 kg/m²), which is still a lower proportion compared with Western countries. Current and past smokers accounted for 26.7% and 12.7%, respectively, compared to 60.6% nonsmokers (response rate, 66.7%). Women had a higher percentage of nonsmokers compared with men (90.9% vs. 32.8%, P<0.001). The 41.3% of the diabetic patients consume one or more alcoholic beverages per month in this analysis. In men, this proportion was 61.5% as compared to 19.5% in women, suggesting a higher rate of alcohol drinking in men (response rate, 66.0%).

COMPLICATIONS

To evaluate the foot disease, end-stage renal disease (ESRD) and ophthalmologic disease, we chose subjects different from the aforementioned data. Foot amputated patients were defined as those who made the first claim in 2003 with code Z894-899 as principal or secondary diagnosis or who had the first record of N0571-N0575 between October 2000 and December 2002 in the health insurance claims data. Foot ulcer patients were defined as those who had the first record in 2003 with L97 (ulcer of lower limb) or R02 (gangrene) as principal or secondary diagnosis. ESRD prevalent patients were defined as those who had the record of chronic renal failure (N18 or N19) as principal or secondary diagnosis in their health insurance claims data between January 2001 and December 2003 and who received renal replacement therapy with one of the following disease classification codes; dialysis (Z49), dependence on renal dialysis (Z99.2), kidney transplant status (Z94.0), or with a specific disease code of V001 (hemodialysis), V003 (peritoneal dialysis), V005 (use of post kidney transplant immunosuppressants), or R3280 (renal transplantation). Renal transplant patients were defined as those with claims of any of the following codes: Z94.0, V005, and R3280. New ESRD incident patients were defined as ESRD patients first diagnosed during 2003.

The 44.8% of the foot amputated patients in 2003 were diabetic. Diabetic patients were 10.1 times more likely to undergo foot amputation (4.7 times after standardization for gender and age), and 7.8 times more likely to have foot ulcer (4.4 times after the standardization). Depending on hospitalization/nonhospitalization, diabetic foot amputation was associated with 1.6 or 2.1 times more annual days of healthcare use than nondiabetic foot amputation. Diabetic foot ulcer was associated with 1.4 or 2.0 times more annual days of healthcare use. Depending on hospitalization/nonhospitalization, diabetic foot amputation was associated with 2.0 or 2.3 times higher total medical cost than nondiabetic foot amputation. Diabetic foot ulcer was associated with 1.7 or 3.2 times higher total medical cost. The results suggest that diabetes is a major underlying disease of foot diseases and that loss of human and/or financial resources to diabetic foot disease should not be underestimated.

Diabetes affected 56.7% of the total prevalent ESRD patients (n=41,167) in Korea in 2003. ESRD was 20.8-fold more common in diabetic patients than non-diabetics (Fig. 4). Of those who newly began renal replacement therapy in 2003, 70.5% were diabetics. Diabetic patients were 1.6 times more likely to be hospitalized due to ESRD for a longer duration compared with nondiabetics. They were also likely to suffer 1.6 times higher hospitalization cost. Ophthalmologic disease including cataract (3.0 times), retinopathy (3.9 times), and glaucoma (1.5 times) was 1.9-fold more common in diabetic patients than nondiabetics. Acute stroke was estimated to be 5.2-fold more common in diabetic patients compared to general population from the small case-control study (Fig. 4) [15]. The results suggest that compared to nondiabetics, complications among patients with diabetes are very common, becoming a heavier burden on the society and leading to a greater loss of human and/or financial resources.

DIABETES MANAGEMENT

We analyzed the 1st nationwide survey data to evaluate the current status of diabetes management. The medical record fill-out rate for family history, smoking history, and drinking history in diabetes patients was low at about 10%, with tertiary hospitals showing the highest rate of record keeping. Basic tests including BMI (18.0% measured over 6 months), blood pressure (56% over 6 months), lipid profile (46.3% over 1 year), and foot examination (6.1% over 2 years) in diabetes patients were being performed in a low portion of the patients. When classified by the type of health institutions, tertiary hospitals showed the highest test rate, followed by general hospitals, hospitals, and clinics. Blood glucose was self-monitored in 34.9% of the subject patients. The 39.4% received education for diabetes management at least once while 60.6% never received such education. Diabetes was treated with oral hypoglycemics alone in 70.0%, with insulin alone in 4.1%, with combination therapy of oral agents and insulin in 10.1%, and with diet/exercise in 15.8% of the patients (Fig. 5). Nonetheless, only 40.3% had their blood glucose controlled to glycated hemoglobin (HbA1c) <7%. These results on treatment methods or control rate were similar to the reports in the 2005 Korea National Health and Nutrition Examination Survey, where HbA1c <7% was observed in 43.5% of the subjects. The 63% of the adult diabetic patients aged 20 to 79 years received antihypertensive medications for more than 1 day a year. While 86.5% of the diabetic patients with comorbid hypertension were taking antihypertensives, blood pressure of <140/90 mm Hg was achieved in 59% and <130/80 mm Hg in only 19%. Similarly, 70.2% of the diabetic patients with comorbid hyperlipidemia received lipid-lowering agents, but only 38% achieved low density lipoprotein-cholesterol of <100 mg/dL (Fig. 6). Only 21.8% of the subject patients took medications for diabetes on a continuous basis (more than 360 days a year). Of the patients with newly diagnosed diabetes in 2003, 36.2%, and 13.2% were taking antihypertensives and lipid-lowering agents, respectively. On the other hand, the percentage of the patients concomitantly taking aspirin was low at 11.6%, which lower than the proportion reported in the United States. These results indicate that current diabetes treatment is not yet aggressive enough.

HEALTH OUTCOME

We reviewed the 1st nationwide survey data to evaluate the death outcome. The 1-, 2-, and 3-year mortality in the diabetes-eligible patients was estimated to be 3.95%, 5.89%, and 8.52%, respectively. In the incident diabetes patients (new patients), the same year mortality was 1.5 to 2 times higher at 7.56%, 9.70%, and 13.11%, respectively. Overall, the mortality due to diabetes was higher in men than women, in newly diagnosed patients than in established patients, and in the age group of 45 to 54 years than the age group of 55 to 64 years. When standard mortality ratio was generated for comparison with the general population, the ratio of diabetes-eligible patients was 3.1, 2.4, and 2.2 at 1, 2, and 3 years, respectively, showing that the gap between the two populations decreased over time. The mortality ratio of the incident diabetes patients was 7.3, 4.9, and 4.2 at 1, 2, and 3 years, respectively, also showing decreasing trend over time. These results suggest that mortality in diabetes patients is 3.1-fold higher than in the general population. The newly diagnosed patients, in particular, shows 7.3-fold higher mortality (adjusted for gender and age difference) (Fig. 4).

USE OF HEALTHCARE SERVICE AND THE COST

The total number of diabetes patients in 2003 was estimated at 2.86 million. Among them, only 52.9% used healthcare service for diabetes at least once a year (48.0% in women, 58.8% in men).

The annual rate of hospitalization in diabetes patients was 10.3%, with an average of 22.4 hospitalization day per year. Patients who received outpatient care made an average of 12.2 visits to health institutions per year. The total medical cost in the adult diabetes patients (aged 20 to 79 years) was 3,185 billion KRW, accounting for about one-fifth (19.2%) of the total cost in the entire adult population. The total medical cost per person in the diabetes patients was 4.6 times higher than the general population. The gap narrowed to a 3-fold difference after adjusting for gender and age. The number of patients who filed insurance claims for diabetes increased by 2.9-fold across a decade, from 800,000 (1.8% of the entire population) in 1995 to 2.33 million (4.8%) in 2005. During the same period, the total medical cost in the patients with diabetes (as principal or secondary diagnosis) increased by as much as 7.99-fold, from 214 billion KRW in 1995 to 1,712 billion KRW in 2005. This large increase was attributable to the increase in the per-capita healthcare service utilization rate to treat diabetes (responsible for 2.09-fold or 35.5% of the increase), population aging (1.40-fold or 16.1%) the increase in healthcare service price index (1.85-fold or 29.7%), and net cost growth after adjustment for the price index (1.48-fold or 18.7%).

These results suggest that the economic burden of diabetes and its management is serious.

CONCLUSIONS

The limitation of this report lies in the inaccuracy of ICD-10 diagnosis code of diabetes. Therefore, the validity of health insurance data is relatively low compared to other well-designed controlled studies. However, we performed face to face field study and telephone survey to randomized samples to overcome the limitation. Despite the slightly low validity, this is the only data to encompass the entire national population. The large size population makes it the best available tool available in foreseeing public health trends.

The prevalence and incidence of diabetes in Korea are predicted to increase until up to year 2030, and the national economic burden subsequently become heavier in the future. A comprehensive effort aiming to decrease the economic burden and comorbidities of diabetes is necessary.

Acknowledgements

ACKNOWLEDGMENTS

We thank the Health Insurance Review & Assessment Service and all the members of Korea Diabetes Association.

NOTES

No potential conflict of interest relevant to this article was reported.

REFERENCES

• 1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004;27:1047-1053. ArticlePubMedPDF
• 2. Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, Zimmet P, Son HY. Epidemic obesity and type 2 diabetes in Asia. Lancet 2006;368:1681-1688. ArticlePubMed
• 3. Kim DJ. The epidemiology of diabetes in Korea. Diabetes Metab J 2011;35:303-308. ArticlePubMedPMC
• 4. Cho NH. The epidemiology of diabetes in Korea: from the economics to genetics. Korean Diabetes J 2010;34:10-15. ArticlePubMedPMC
• 5. Park Y, Lee H, Koh CS, Min H, Yoo K, Kim Y, Shin Y. Prevalence of diabetes and IGT in Yonchon County, South Korea. Diabetes Care 1995;18:545-548. ArticlePubMedPDF
• 6. International Diabetes Federation. World Diabetes Foundation. Diabetes atlas. 2nd ed. Brussels: International Diabetes Federation; 2003.
• 7. Korea Centers for Disease Control and Prevention. In-depth analyses for diabetes with data of the 3rd Korea National Health and Nutrition Examination Survey (2005). Cheongwon: Korea Centers for Disease Control and Prevention; 2007. p. 158-204.
• 8. Task Force Team for Basic Statistical Study of Korean Diabetes Mellitus. Report of task force team for basic statistical study of Korean diabetes mellitus: diabetes in Korea 2007. 1st ed. Seoul: Goldfishery; 2007.
• 9. Park SW, Kim DJ, Min KW, Baik SH, Choi KM, Park IB, Park JH, Son HS, Ahn CW, Oh JY, Lee J, Chung CH, Kim J, Kim H. Current status of diabetes management in Korea using National Health Insurance Database. J Korean Diabetes Assoc 2007;31:362-367.Article
• 10. Park IB, Kim DJ, Kim J, Kim H, Min KW, Park SW, Park JH, Son HS, Ahn CW, Oh J, Lee S, Lee IB, Lee J, Chung CH, Choi I, Choi KM, Baik SH. Joint research of Korean Diabetes Association-Health Insurance Review and Assessment Service 2004-2007. Clin Diabetes 2007;8:356-360.
• 11. Lee JS, Kim J, Baik SH, Park IB, Lee J. An evaluation of sampling design for estimating an epidemiologic volume of diabetes and for assessing present status of its control in Korea. J Prev Med Public Health 2009;42:135-142. ArticlePubMed
• 12. Kim DJ, Kim J, Kim H, Min KW, Park SW, Park IB, Park JH, Baik SH, Son HS, Ahn CW, Oh JY, Lee S, Lee J, Chung CH, Choi KM, Choi I, Kim H. Current status of diabetic end-stage renal disease using Korean Health Insurance database. J Korean Diabetes Assoc 2006;30:355-362.Article
• 13. Chung CH, Kim DJ, Kim J, Kim H, Kim H, Min KW, Park SW, Park JH, Baik SH, Son HS, Ahn CW, Oh JY, Lee S, Lee J, Choi KM, Choi I, Park IB. Current status of diabetic foot in Korean patients using National Health Insurance database. J Korean Diabetes Assoc 2006;30:372-376.Article
• 14. Kim J, Kim H, Kim H, Min KW, Park SW, Park IB, Park JH, Baik SH, Son HS, Ahn CW, Oh JY, Lee S, Lee J, Chung CH, Choi KM, Choi I, Kim DJ. Current status of the continuity of ambulatory diabetes care and its impact on health outcomes and medical cost in Korea using National Health Insurance database. J Korean Diabetes Assoc 2006;30:377-387.Article
• 15. Kim J. Construction of national surveillance system for cardiovascular & cerebrovascular diseases. Seoul: Health Insurance Review & Assessment Service; 2006.

Fig. 1

Overview of the study. HIRA, Health Insurance Review & Assessment Service.

Fig. 2

Diabetic population estimates from 2003 to 2030 in Korea.

Fig. 3

Diabetic population estimates factoring in age structure changes.

Fig. 4

Relative risk of comorbidities and health outcome compared with nondiabetics by simple comparison.

Fig. 5

Blood glucose control methods in the diabetes-eligible patients.

Fig. 6

Percentage of patients achieving treatment targets (%). HbA1c, glycated hemoglobin; BP, blood pressure; LDL, low density lipoprotein cholesterol.

Figure & Data

References

Citations

Citations to this article as recorded by  

• Revisiting the Diabetes Crisis in Korea: Call for Urgent Action
  Jun Sung Moon
  The Journal of Korean Diabetes.2023; 24(1): 1.     CrossRef
• Risk assessment and classification for foot ulceration among patients with type 2 diabetes in South Korea
  Eun Joo Lee, Ihn Sook Jeong, In Ju Kim, Young Hye Cho, Yun Jin Kim
  International Journal of Nursing Practice.2022;[Epub]     CrossRef
• Using real-world data for supporting regulatory decision making: Comparison of cardiovascular and safety outcomes of an empagliflozin randomized clinical trial versus real-world data
  Ha Young Jang, In-Wha Kim, Jung Mi Oh
  Frontiers in Pharmacology.2022;[Epub]     CrossRef
• Differences in health behavior and nutrient intake status between diabetes-aware and unaware Korean adults based on the Korea national health and nutrition examination survey 2016–18 data: A cross-sectional study
  Anshul Sharma, Chen Lulu, Kee-Ho Song, Hae-Jeung Lee
  Frontiers in Public Health.2022;[Epub]     CrossRef
• Do statins benefit low-risk population for primary prevention of atherosclerotic cardiovascular disease: A retrospective cohort study
  In Sun Ryou, Ju Young Kim, Hwa Yeon Park, Sohee Oh, Sehun Kim, Hwa Jung Kim
  Frontiers in Medicine.2022;[Epub]     CrossRef
• Association between oseltamivir use and neuropsychiatric adverse events in influenza patients: a nationwide population-based cohort study
  Hye-Rim Kang, Suk-Chan Jang, Ju-Young Shin
  Expert Opinion on Drug Safety.2021; 20(2): 245.     CrossRef
• Effectiveness and safety of sodium‐glucose co‐transporter‐2 inhibitors compared with dipeptidyl peptidase‐4 inhibitors in older adults with type 2 diabetes: A nationwide population‐based study
  Seung Jin Han, Kyoung Hwa Ha, Nami Lee, Dae Jung Kim
  Diabetes, Obesity and Metabolism.2021; 23(3): 682.     CrossRef
• Cost-Effectiveness of Tiotropium in Elderly Patients with Severe Asthma Using Real-World Data
  Sung-Hyun Hong, Jeong-Yeon Cho, Tae-Bum Kim, Eui-Kyung Lee, Sun-Hong Kwon, Ju-Young Shin
  The Journal of Allergy and Clinical Immunology: In Practice.2021; 9(5): 1939.     CrossRef
• Dapagliflozin improves cardiovascular risk factors in Emirati patients with T2DM
  Aml Mohamed Nada, Mariam Adel Younan
  Therapeutic Advances in Endocrinology and Metabolism.2021; 12: 204201882199536.     CrossRef
• Association between socioeconomic position and diabetic foot ulcer outcomes: a population-based cohort study in South Korea
  Jeong Hyun Ha, Heejin Jin, Ji-Ung Park
  BMC Public Health.2021;[Epub]     CrossRef
• Etiology, diagnosis, complications, and treatments of diabetic foot
  Dong-Kyo Seo
  Journal of the Korean Medical Association.2021; 64(8): 523.     CrossRef
• Hospital admissions due to endocrine diseases in Korean male firefighters
  Seunghoon Ryu, Yong-Jin Lee, Eun-Chul Jang, Soon-Chan Kwon, KiSeok Kim, Yeon-Soon Ahn, Young-Sun Min
  Annals of Occupational and Environmental Medicine.2021;[Epub]     CrossRef
• Association between Frequency of Breakfast Consumption and Insulin Resistance Using Triglyceride-Glucose Index: A Cross-Sectional Study of the Korea National Health and Nutrition Examination Survey (2016–2018)
  Hye Jin Joo, Gyu Ri Kim, Eun-Cheol Park, Sung-In Jang
  International Journal of Environmental Research and Public Health.2020; 17(9): 3322.     CrossRef
• Review of Diabetic Foot Complication Assessment Tools Developed from 2007 to 2016
  Yoonhee Lee, Youngshin Song
  Journal of Korean Academy of Fundamentals of Nursing.2019; 26(4): 231.     CrossRef
• Associations between Breastfeeding and Type 2 Diabetes Mellitus and Glycemic Control in Parous Women: A Nationwide, Population-Based Study
  Ga Eun Nam, Kyungdo Han, Do-Hoon Kim, Youn Huh, Byoungduck Han, Sung Jung Cho, Yong Gyu Park, Yong-Moon Park
  Diabetes & Metabolism Journal.2019; 43(2): 236.     CrossRef
• Risk of osteoporosis in patients with chronic inflammatory neuropathy- a population-based cohort study
  Seung Woo Kim, Eun Hwa Kim, Jinae Lee, Young-Chul Choi, Seung Min Kim, Ha Young Shin
  Scientific Reports.2019;[Epub]     CrossRef
• Differences in the risk of mood disorders in patients with asthma-COPD overlap and in patients with COPD alone: a nationwide population-based retrospective cohort study in Korea
  Hye-Rim Kang, Sung-Hyun Hong, So-Young Ha, Tae-Bum Kim, Eui-Kyung Lee
  Respiratory Research.2019;[Epub]     CrossRef
• A Comparison of Leukotriene Receptor Antagonists to Low-Dose Inhaled Corticosteroids in the Elderly with Mild Asthma
  Sung-Hyun Hong, Hye-Rim Kang, Jin Hyun Nam, Sun-Kyeong Park, Tae-Bum Kim, Eui-Kyung Lee
  The Journal of Allergy and Clinical Immunology: In Practice.2019; 7(8): 2642.     CrossRef
• The Need to Improve the Quality of Diabetes Care in Korea
  Seung Jin Han, Dae Jung Kim
  Journal of Korean Medical Science.2019;[Epub]     CrossRef
• Fifty Years of Compassionate Care and Harmonious Collaboration of the Korean Diabetes Association: The 50th Anniversary of Korean Diabetes Association
  Jong Chul Won, Eun-Jung Rhee, Hyung Joon Yoo
  Diabetes & Metabolism Journal.2018; 42(6): 475.     CrossRef
• Depth and combined infection is important predictor of lower extremity amputations in hospitalized diabetic foot ulcer patients
  Eun-Gyo Jeong, Sung Shim Cho, Sang-Hoon Lee, Kang-Min Lee, Seo-Kyung Woo, Yoongoo Kang, Jae-Seung Yun, Seon-Ah Cha, Yoon-Jung Kim, Yu-Bae Ahn, Seung-Hyun Ko, Jung-Min Lee
  The Korean Journal of Internal Medicine.2018; 33(5): 952.     CrossRef
• Favorable glycemic response after pancreatoduodenectomy in both patients with pancreatic cancer and patients with non-pancreatic cancer
  Seo Young Sohn, Eun Kyung Lee, Sung-Sik Han, You Jin Lee, Yul Hwangbo, Young Hwa Kang, Seung Duk Lee, Seong Hoon Kim, Sang Myung Woo, Woo Jin Lee, Eun Kyung Hong, Sang-Jae Park
  Medicine.2018; 97(18): e0590.     CrossRef
• Clinical Importance of Diabetic Neuropathy
  Tae Sun Park
  The Journal of Korean Diabetes.2018; 19(3): 147.     CrossRef
• Women are less likely than men to achieve optimal glycemic control after 1 year of treatment: A multi-level analysis of a Korean primary care cohort
  Seung-Ah Choe, Joo Yeong Kim, Young Sun Ro, Sung-Il Cho, Antonio Palazón-Bru
  PLOS ONE.2018; 13(5): e0196719.     CrossRef
• Diagnosis and Management of Diabetic Foot
  Chang Won Lee
  The Journal of Korean Diabetes.2018; 19(3): 168.     CrossRef
• HbA1c Cutoff for Prediabetes and Diabetes Based on Oral Glucose Tolerance Test in Obese Children and Adolescents
  Hyo-Kyoung Nam, Won Kyoung Cho, Jae Hyun Kim, Young-Jun Rhie, Sochung Chung, Kee-Hyoung Lee, Byung-Kyu Suh
  Journal of Korean Medical Science.2018;[Epub]     CrossRef
• Diabetes Fact Sheet in Korea, 2016: An Appraisal of Current Status
  Jong Chul Won, Jae Hyuk Lee, Jae Hyeon Kim, Eun Seok Kang, Kyu Chang Won, Dae Jung Kim, Moon-Kyu Lee
  Diabetes & Metabolism Journal.2018; 42(5): 415.     CrossRef
• Risk factors of asthma exacerbation based on asthma severity: a nationwide population-based observational study in South Korea
  Hye-Rim Kang, Hyun Jin Song, Jin Hyun Nam, Sung-Hyun Hong, So-Young Yang, SangEun Ju, Sang Won Lee, Tae-Bum Kim, Hye-Lin Kim, Eui-Kyung Lee
  BMJ Open.2018; 8(3): e020825.     CrossRef
• Foot Care for Diabetic Patients
  Hye Jung Cha
  The Journal of Korean Diabetes.2018; 19(1): 41.     CrossRef
• Risk of new-onset diabetes among patients treated with statins according to hypertension and gender: Results from a nationwide health-screening cohort
  Sang-Eun Lee, Ji Min Sung, In-Jeong Cho, Hyeon Chang Kim, Hyuk-Jae Chang, Lamberto Manzoli
  PLOS ONE.2018; 13(4): e0195459.     CrossRef
• Treatment variation related to comorbidity and complications in type 2 diabetes
  Yeon Young Cho, Sung-il Cho
  Medicine.2018; 97(37): e12435.     CrossRef
• Efficacy of Body Weight Reduction on the SGLT2 Inhibitor in People with Type 2 Diabetes Mellitus
  Hyun A Cho, Young Lee Jung, Yong Hoon Lee, Yu Chang Lee, Jung Eun Lee, Sol Jae Lee, Su Jin Jeong, Chong Hwa Kim
  Journal of Obesity & Metabolic Syndrome.2017; 26(2): 107.     CrossRef
• Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
  Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
  Diabetes & Metabolism Journal.2017; 41(3): 187.     CrossRef
• Current status of managing diabetes mellitus in Korea
  Kyoung Hwa Ha, Dae Jung Kim
  The Korean Journal of Internal Medicine.2016; 31(5): 845.     CrossRef
• 7^th Asian PAD Workshop
  
  Annals of Vascular Diseases.2016; 9(2): 135.     CrossRef
• Trends in Diabetes Incidence in the Last Decade Based on Korean National Health Insurance Claims Data
  Sun Ok Song, Yong-ho Lee, Dong Wook Kim, Young Duk Song, Joo Young Nam, Kyoung Hye Park, Dae Jung Kim, Seok Won Park, Hyun Chul Lee, Byung-Wan Lee
  Endocrinology and Metabolism.2016; 31(2): 292.     CrossRef
• Trends of antidiabetic drug use in adult type 2 diabetes in Korea in 2002–2013
  Seung-Hyun Ko, Dae-Jung Kim, Jong-Heon Park, Cheol-Young Park, Chang Hee Jung, Hyuk-Sang Kwon, Joong-Yeol Park, Kee-Ho Song, Kyungdo Han, Ki-Up Lee, Kyung-Soo Ko
  Medicine.2016; 95(27): e4018.     CrossRef
• Glycosylated Hemoglobin Threshold for Predicting Diabetes and Prediabetes from the Fifth Korea National Health and Nutrition Examination Survey
  Sangmo Hong, Jun Goo Kang, Chul Sik Kim, Seong Jin Lee, Cheol-Young Park, Chang Beom Lee, Sung-Hee Ihm
  Diabetes & Metabolism Journal.2016; 40(2): 167.     CrossRef
• Predictive Value of Glucose Parameters Obtained From Oral Glucose Tolerance Tests in Identifying Individuals at High Risk for the Development of Diabetes in Korean Population
  Hae Kyung Yang, Hee-Sung Ha, Marie Rhee, Jin-Hee Lee, Yong-Moon Park, Hyuk-Sang Kwon, Hyeon-Woo Yim, Moo-Il Kang, Won-Chul Lee, Ho-Young Son, Seung-Hwan Lee, Kun-Ho Yoon
  Medicine.2016; 95(10): e3053.     CrossRef
• Serum preadipocyte factor 1 concentrations and risk of developing diabetes: a nested case–control study
  S. H. Lee, M. Rhee, H. K. Yang, H. S. Ha, J. H. Lee, H. S. Kwon, Y. M. Park, H. W. Yim, M. I. Kang, W. C. Lee, H. Y. Son, K. H. Yoon
  Diabetic Medicine.2016; 33(5): 631.     CrossRef
• Is an Oral Glucose Tolerance Test Still Valid for Diagnosing Diabetes Mellitus?
  Dong-Lim Kim, Sun-Doo Kim, Suk Kyeong Kim, Sooyoun Park, Kee-Ho Song
  Diabetes & Metabolism Journal.2016; 40(2): 118.     CrossRef
• Fasting plasma glucose concentrations for specified HbA1c goals in Korean populations: data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-2, 2011)
  Sangmo Hong, Jun Goo Kang, Chul Sik Kim, Seong Jin Lee, Chang Beom Lee, Sung-Hee Ihm
  Diabetology & Metabolic Syndrome.2016;[Epub]     CrossRef
• Combined use of basal insulin analog and acarbose reduces postprandial glucose in patients with uncontrolled type 2 diabetes
  Ji‐Hyun Kim, Ji‐Hyun Ahn, Soo‐Kyung Kim, Dae‐Ho Lee, Hye‐Soon Kim, Ho‐Sang Shon, Hyun‐Jeong Jeon, Tae‐Hwa Kim, Yong‐Wook Cho, Jae‐Taek Kim, Sung‐Min Han, Choon‐Hee Chung, Ohk‐Hyun Ryu, Jae‐Min Lee, Soon‐Hee Lee, Min‐Jeong Kwon, Tae‐kyun Kim, Il‐Seong Namg
  Journal of Diabetes Investigation.2015; 6(2): 219.     CrossRef
• Anti-Oxidative and Anti-Diabetic Effects of Methanol Extracts from Medicinal Plants
  Youn Ri Lee, Nara Yoon
  Journal of the Korean Society of Food Science and Nutrition.2015; 44(5): 681.     CrossRef
• Associations Between the Continuity of Ambulatory Care of Adult Diabetes Patients in Korea and the Incidence of Macrovascular Complications
  Young-Hoon Gong, Seok-Jun Yoon, Hyeyoung Seo, Dongwoo Kim
  Journal of Preventive Medicine and Public Health.2015; 48(4): 188.     CrossRef
• Statin eligibility and cardiovascular risk burden assessed by coronary artery calcium score: Comparing the two guidelines in a large Korean cohort
  Eun-Jung Rhee, Se Eun Park, Hyung Geun Oh, Cheol-Young Park, Ki-Won Oh, Sung-Woo Park, Ron Blankstein, Jorge Plutzky, Won-Young Lee
  Atherosclerosis.2015; 240(1): 242.     CrossRef
• Evaluation of low-dose aspirin for primary prevention of ischemic stroke among patients with diabetes: a retrospective cohort study
  Ye-Jee Kim, Nam-Kyong Choi, Mi-Sook Kim, Joongyub Lee, Yoosoo Chang, Jong-Mi Seong, Sun-Young Jung, Ju-Young Shin, Ji-Eun Park, Byung-Joo Park
  Diabetology & Metabolic Syndrome.2015;[Epub]     CrossRef
• Health-Related Quality of Life in Coronary Heart Disease in Korea
  Hyung Tak Lee, Jinho Shin, Young-Hyo Lim, Kyung Soo Kim, Soon Gil Kim, Jeong Hyun Kim, Heon Kil Lim
  Angiology.2015; 66(4): 326.     CrossRef
• Seroepidemiology of varicella-zoster virus in Korean adolescents and adults using fluorescent antibody to membrane antigen test
  S. B. HAN, K. R. KANG, D. H. HUH, H. C. LEE, J. H. KIM, J. H. KANG, S. H. MA
  Epidemiology and Infection.2015; 143(8): 1643.     CrossRef
• Changing Clinical Characteristics according to Insulin Resistance and Insulin Secretion in Newly Diagnosed Type 2 Diabetic Patients in Korea
  Jang Won Son, Cheol-Young Park, Sungrae Kim, Han-Kyu Lee, Yil-Seob Lee
  Diabetes & Metabolism Journal.2015; 39(5): 387.     CrossRef
• Age- and Sex-Specific Relationships between Household Income, Education, and Diabetes Mellitus in Korean Adults: The Korea National Health and Nutrition Examination Survey, 2008-2010
  So-Ra Kim, Kyungdo Han, Jin-Young Choi, Jennifer Ersek, Junxiu Liu, Sun-Jin Jo, Kang-Sook Lee, Hyeon Woo Yim, Won-Chul Lee, Yong Gyu Park, Seung-Hwan Lee, Yong-Moon Park, C. Mary Schooling
  PLOS ONE.2015; 10(1): e0117034.     CrossRef
• Association between Diabetes Education Status and Clinical Outcomes of Patients with Diabetes Mellitus: Analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V)
  Jun Sung Kwon, Won Jun Kim, Yang Hee Han, Hyun Joong Kim, Sa Young Shin, Kyoo Ho Choi, Jae Hyuck Jun, Myoung Sook Shim, Jin Yeob Kim
  The Journal of Korean Diabetes.2014; 15(4): 236.     CrossRef
• The Incidence and Prevalence of Diabetes Mellitus and Related Atherosclerotic Complications in Korea: A National Health Insurance Database Study
  Bo Kyung Koo, Chang-Hoon Lee, Bo Ram Yang, Seung-sik Hwang, Nam-Kyong Choi, Mohammad Ebrahim Khamseh
  PLoS ONE.2014; 9(10): e110650.     CrossRef
• Current Status of Glycemic Control of Patients with Diabetes in Korea: The Fifth Korea National Health and Nutrition Examination Survey
  Ja Young Jeon, Dae Jung Kim, Seung-Hyun Ko, Hyuk-Sang Kwon, Soo Lim, Sung Hee Choi, Chul Sik Kim, Jee Hyun An, Nan Hee Kim, Jong Chul Won, Jae Hyeon Kim, Bong-Yun Cha, Kee-Ho Song
  Diabetes & Metabolism Journal.2014; 38(3): 197.     CrossRef
• Strong correlation between glycaemic variability and total glucose exposure in type 2 diabetes is limited to subjects with satisfactory glycaemic control
  S. Suh, J.Y. Joung, S.M. Jin, M.Y. Kim, J.C. Bae, H.D. Park, M.S. Lee, M.K. Lee, J.H. Kim
  Diabetes & Metabolism.2014; 40(4): 272.     CrossRef
• Current Status of Diabetic Peripheral Neuropathy in Korea: Report of a Hospital-Based Study of Type 2 Diabetic Patients in Korea by the Diabetic Neuropathy Study Group of the Korean Diabetes Association
  Jong Chul Won, Sang Soo Kim, Kyung Soo Ko, Bong-Yun Cha
  Diabetes & Metabolism Journal.2014; 38(1): 25.     CrossRef
• Impact of Age at First Childbirth on Glucose Tolerance Status in Postmenopausal Women: The 2008–2011 Korean National Health and Nutrition Examination Survey
  Jin Hwa Kim, Yun Jung, Sang Yong Kim, Hak Yeon Bae
  Diabetes Care.2014; 37(3): 671.     CrossRef
• Predicting the Development of Diabetes Using the Product of Triglycerides and Glucose: The Chungju Metabolic Disease Cohort (CMC) Study
  Seung-Hwan Lee, Hyuk-Sang Kwon, Yong-Moon Park, Hee-Sung Ha, Seung Hee Jeong, Hae Kyung Yang, Jin-Hee Lee, Hyeon-Woo Yim, Moo-Il Kang, Won-Chul Lee, Ho-Young Son, Kun-Ho Yoon, Maria Eugenia Saez
  PLoS ONE.2014; 9(2): e90430.     CrossRef
• Relationship between socioeconomic status and type 2 diabetes: results from Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012
  Jongnam Hwang, Changwoo Shon
  BMJ Open.2014; 4(8): e005710.     CrossRef
• Diabetes Mellitus and Osteoporosis
  Kyoung Min Kim
  The Journal of Korean Diabetes.2013; 14(4): 186.     CrossRef
• Study on the Correlation between the Nutrient Intakes and Clinical Indices of Type 2 Diabetes Patients
  Ji-Young Kwon, Hae-Yun Chung
  The Korean Journal of Food And Nutrition.2013; 26(4): 909.     CrossRef
• Role of Sarcopenia in Diabetes Mellitus
  Sang Youl Rhee
  The Journal of Korean Diabetes.2013; 14(4): 178.     CrossRef

About this article

, Park IB, Kim J, Kim DJ, Chung CH, Oh JY, Park SW, Lee J, Choi KM, Min KW, Park JH, Son HS, Ahn CW, Kim H, Lee S, Lee IB, Choi I, Baik SH. Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes "Diabetes in Korea 2007". Diabetes Metab J. 2013;37(4):233-239.

DOI: https://doi.org/10.4093/dmj.2013.37.4.233.

Download citation ↓