Skip Navigation
Skip to contents

Diabetes Metab J : Diabetes & Metabolism Journal

Search
OPEN ACCESS

Articles

Page Path
HOME > Diabetes Metab J > Volume 46(2); 2022 > Article
Original Article
Metabolic Risk/Epidemiology Prevalence of Type 2 Diabetes Mellitus among Korean Children, Adolescents, and Adults Younger than 30 Years: Changes from 2002 to 2016
Yong Hee Hong1orcid, In-Hyuk Chung2, Kyungdo Han3, Sochung Chung4,5orcid, on Behalf of the Taskforce Team of the Obesity Fact Sheet of the Korean Society for the Study of Obesity
Diabetes & Metabolism Journal 2022;46(2):297-306.
DOI: https://doi.org/10.4093/dmj.2021.0038
Published online: October 26, 2021
  • 9,557 Views
  • 346 Download
  • 9 Web of Science
  • 14 Crossref
  • 11 Scopus

1Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea

2Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Goyang, Korea

3Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea

4Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

5Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea

Corresponding author: Sochung Chung orcid Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, 20-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea E-mail: 20010029@kuh.ac.kr
• Received: March 5, 2021   • Accepted: August 2, 2021

Copyright © 2022 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • Background
    Despite the importance of and social concern regarding prevention of diabetes at younger ages, limited data are available. This study sought to analyze changes in the prevalence of type 2 diabetes mellitus (T2DM) in Koreans younger than 30 years according to sex, age, and level of income.
  • Methods
    The dataset analyzed in this study was derived from health insurance claims recorded in the National Health Insurance Service (NHIS) database. Participants’ level of income was categorized as low (quintile 1, <20% of insurance premium) or others (quintile 2–5).
  • Results
    In males and females, the prevalence of T2DM per 10,000 people steadily increased from 2.57 in 2002 to 11.41 in 2016, and from 1.96 in 2002 to 8.63 in 2016. The prevalence of T2DM in girls was higher in the age group of 5 to 14 years. Even though the prevalence was higher among those older than 20 years, the increase had started earlier, in the early 2000s, in younger age group. Adolescents aged 10 to 19 years in low-income families showed a remarkable increase in prevalence of T2DM, especially in boys.
  • Conclusion
    The prevalence of T2DM in young Koreans increased more than 4.4-fold from 2002 to 2016, and the increase started in the early 2000s in younger age groups and in low-income families. This is the first study to examine the trend in prevalence of T2DM in children, adolescents, and young adults in Korea. Future studies and collaborations with social support systems to prevent T2DM at an early age group should be performed.
Type 2 diabetes mellitus (T2DM) in young patients is on the rise given the increasing burden of obesity worldwide. In the United States, T2DM has been described as a new epidemic affecting the pediatric population [1]. The prevalence of T2DM in Korean adults aged ≥30 years increased 0.2% to 0.5% annually [2]. Similar to older-onset T2DM, the major predisposing risk factors for T2DM in children are obesity, family history, and a sedentary lifestyle [3]. Earlier onset of T2DM is associated with long-term disease exposure and an increased risk for chronic complications. Younger age at T2DM onset leads to more rapid deterioration of β-cell function [4] and was linked to more severe disease and an accelerated development of complications [5], as recently exemplified by the finding of an increased risk for cardiovascular mortality in this population [6,7]. A diagnosis of T2DM made in adolescence is predicted to shorten an individual’s life expectancy by 15 years relative to that of peers without T2DM [8]. Furthermore, T2DM has a disrupting effect on young people during their most productive and active years [9]. As such, in addition to its health impacts, the economic and social impacts of early-onset T2DM are concerning.
Diabetes affects 422 million people worldwide, and the global prevalence has been growing, with a disproportionate rise in numbers of younger patients [3]. Despite the importance of and social concern concerning the prevention of diabetes at younger ages and there were data of the prevalence of T2DM in Korean adults [2], limited data and reports exist in Koreans younger than 30 years. This study therefore sought to analyze changes in the prevalence of T2DM in Koreans younger than 30 years according to sex, age, and level of income based on health insurance premiums using national data.
Data source
A compulsory National Health Insurance Service (NHIS) program was launched by the Korean government in February 1999. As of 2020, the NHIS program covers the entire population of South Korea. The dataset analyzed in this study was derived from health insurance claims recorded in the NHIS claims database, from which the NHIS provided data after deidentification. The claims case data contained patients’ age, sex, and level of income. The study protocol was reviewed and approved by the Konkuk University Medical Center Institutional Review Board (approval no. KUH1090064) and permission for the use of NHIS data was granted by the NHIS for the research (NHIS-2019-1-069). The need for written informed consent from the participants was waived due to the retrospective nature of this study.
Study population
Using NHIS claims data gathered from January 1, 2002 to December 31, 2016, we extracted information on patients (age <30 years) with T2DM for each year. In this study, patient with T2DM were defined as those with at least one claim with a principal or first additional diagnosis of diabetes, based on International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes for diabetes (E1000–E1090, type 1 diabetes mellitus [T1DM]; E1100–E1190, T2DM; E1200–E1290, malnutrition-related diabetes; E1300–E1390, diabetes associated with other diseases, other type of diabetes; and E1400–E1490, diabetes type unknown, unknown diabetes) and the concurrent prescription of anti-diabetic medications. We excluded patients with codes for T1DM (E1000–E1090) and those treated with only insulin for more than 1 year. Because it is a prevalence study, there are overlapping numbers between years. However, just because a patient received multiple claims in the same year does not count as a duplicate number. The data were extracted on August 30, 2018. For more detailed subanalyses, patients were stratified by sex and age group (0–4, 5–9, 10–14, 15–19, 20–24, and 25–29 years). Participants’ level of income was estimated using the health insurance premium and divided into five quintiles based on the National Health Insurance fee imposed on each household, categorized arbitrary as low group (quintile 1, <20% of insurance premium) or others (quintile 2–5, except for the low group).
Statistical analysis
All data were analyzed using the SAS version 9.3 software program (SAS Institute Inc., Cary, NC, USA). We conducted the analysis in accordance with sex and age groups (0–4, 5–9, 10–14, 15–19, 20–24, and 25–29 years). The prevalence rates of T2DM for each year from 2002 to 2016 were calculated by dividing the number of patients with T2DM by the total number of health insurance recipients. We used the Cochran-Armitage trend test to estimate the P value for the time trends. A P value of less than 0.05 was considered to be statistically significant.
Table 1 shows the prevalence of T2DM in 2002 and 2016, respectively. Between 2002 and 2016, the prevalence of T2DM in Korean children, adolescents, and young adults younger than 30 years of age was 2.27 and 10.08 per 10,000 people, respectively, exhibiting a significant increase by 4.43 times. The prevalence increased exponentially with age, being three-fold greater in the 15 to 19 years age group than in the 10 to 14 years age group in both 2002 and 2016.
The prevalence rates of T2DM from 2002 to 2016 are presented in Table 2 and depicted graphically in Fig. 1. A gradual and constant increase in the prevalence of T2DM was observed, affecting both sexes similarly: in male and female individuals, respectively, the prevalence of T2DM steadily increased from 2.57 in 2002 to 11.41 in 2016 (P for trend <0.0001) and from 1.96 in 2002 to 8.63 in 2016 (P for trend <0.0001), respectively. Fig. 2 shows the prevalence of T2DM by sex and age group. In the age group of 0 to 4 years, no significant change was observed; however, the remaining four age groups experienced a remarkable increase the prevalence of T2DM from 2002 to 2016. Cases of T2DM displayed a female predominance from the ages of 5 to 14 years and a male predominance in those older than 20 years; male patients overtook female ones in terms of T2DM prevalence somewhere between 15 and 19 years of age.
Also, the prevalence of T2DM increased rapidly among both boys and girls aged older than 10 years with low income (Table 3, Fig. 3, Supplementary Table 1). Notably, from 2006, the prevalence of T2DM has increased significantly in the male, low-income, and 10 to 14 years age group, while, in 2013, the increase was predominantly observed in the 20 years and older age group.
This nationwide study using nationwide Korean claims data investigated trends in the prevalence of T2DM in individuals younger than 30 years of age. Despite concerns about increasing rates of obesity and T2DM, limited data exist regarding trends in the prevalence of T2DM in Koreans, including among children, adolescents, and young adults, especially stratified according to income level. To our knowledge, we present the first estimates of recent changes in T2DM prevalence rates among Koreans younger than 30 years of age using NHIS data according to age, sex, and level of income.
The growing worldwide prevalence of T2DM in young people [10] has emphasized the need for identification and treatment of this condition in children and adolescents. T2DM has accounted for a significant number of adolescents with diabetes recently. Available global data indicate considerable variations in incidence and prevalence, depending on ethnicity and geographical region. In the SEARCH for Diabetes in Youth study [11], the overall prevalence of T2DM among youth between 2001 and 2009 increased by 30.5%, rising with age. Relatively few population-based datasets are available concerning the prevalence of T2DM in Asia. In Japan, 80% of all new cases of diabetes in children and adolescents are diagnosed as T2DM [12]. Likewise, in Taiwan, 54.2% of new cases are diagnosed as T2DM, with an incidence of 6.5 per 100,000 people [12]. In China, in 2002 and 2012, the prevalence rates of diabetes were 0.24% and 0.52% among children and adolescents aged seven to 17 years, respectively [13]. Other Chinese data suggest the prevalence of T2DM among those younger than 18 years has increased from 4.1 in 1995 to 7.1 and 10.0 in 2010, respectively [14]. A gradual and constant increase in the prevalence rate of T2DM in Koreans younger than 30 years of age was observed from 2002 to 2016 in our study.
In this study, we found that T2DM occurs increasingly frequently as children progress through puberty. Puberty is associated with significant changes in physiology, including a transient reduction in insulin sensitivity [15]. As compensation, insulin secretion must increase reciprocally, which may lead to hyperglycemia in youth with limited β-cell capacity due to genetic, epigenetic, and/or lifestyle factors [5]. Thus, puberty creates a high-risk time for diabetes development in susceptible individuals.
Youth-onset T2DM has a sex ratio (male:female) that varies from 1:4 to 1:6 in native North Americans and is 1:1 in Asians and Libyan Arabs [16]. In the SEARCH study of American children and adolescents, the incidence of T2DM in girls was nearly twice that in boys [17]. In China, the prevalence of T2DM in boys is higher than in girls [14]. In this Korean study, the overall prevalence of T2DM showed a male predominance and the prevalence of diabetes in boys increased after the age of 15 years. It is presumed that this trend is probably due to the male predominance among children and adolescents in Korea with extreme obesity [18].
A substantial proportion of young people with T2DM live in poverty or socially disadvantaged households [19]. The SEARCH for Diabetes in Youth study reported a 44% prevalence rate of poverty [20], and while the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) cohort demonstrated a 41% prevalence rate of poverty in adolescents and youth with T2DM [21]. According to the T1DM cohort of the Pediatric Diabetes Consortium [22], the family income and parental education were relatively high, but, in the T2DM cohort, 43% of participants lived in a household with an income of less than 25,000 United States Dollars per year [23]. Diabetes care providers need to be aware of these characteristics and the increased difficulties faced by youth with T2DM and should consider how this might affect patient management. A previous Korean nationwide study indicated that the incidence rates of T2DM and diabetes-related morbidity were higher among diabetic subjects who were over 30 years of age with a lower socioeconomic status [24]. In the United States and Europe, youth-onset T2DM has been predominantly found in populations characterized by a low socioeconomic and educational status, whereas, in emerging countries like China and India, more affluent children are more likely to develop T2DM [16]. In our study, there were varying prevalence rates of T2DM observed according to age, sex, and income level. Generally, the low-income group had a higher prevalence rate than did the high-income group, in correlation with findings from the United States and Europe. Boys in low-income families aged 10 to 19 years showed a remarkable increase in the prevalence of T2DM. Even though the prevalence was highest among those older than 20 years of age, the rise in prevalence rate had started already from 2006 in boys in low-income families aged 10 to 14 years, suggesting the trend initiated earlier than that seen in the age group of 20 to 29 years.
Although the overall prevalence of T2DM in American youth is low (0.046% in 2009 per the SEARCH for Diabetes in Youth study), it has increased by 30% from 2001 [11]. We can predict the same phenomenon is likely in the Korean youth. The prevalence of T2DM in Korean adults aged ≥30 years increased 0.2% to 0.5% annually, from 5.6% in 2006 to 8% in 2013 and 13.8% of Korean adults aged ≥30 years had diabetes in 2018 [2,25]. In this study, compared to 2002 and 2016, the fold-increase was 4.43 in Koreans younger than 30 years. Although the number of T2DM patients in Koreans younger than 30 years is smaller than adults aged ≥30 years, the trend seems to outweigh that of adults aged ≥30 years.
The prevalence of obesity among children and adolescents in Korea increased nine times in males and four times in females from 1979 to 2002 [26,27]. Also after the 2000’s, the prevalence of obesity increased from 8.7% in 2007 to 15.0% in 2017 in the National School Health Examination in Korean children aged 6 to 18 years [28]. The prevalence of adult obesity increased across all age groups, especially in the 20s, 30s [29]. From 2009 to 2018, the prevalence of obesity in males aged 20 to 29 years was 18.5% in 2009 to 27.5%. In females aged 20 to 29 years, the prevalence of obesity increased from 8.6% in 2009 to 15.4% in 2018 [29]. This increase in obesity may have affected to the rapid increase in the prevalence of T2DM in Koreans younger than 30 years.
In future research, increasing the number of patients is important, but it is not a good indicator for the early detection of the changes in disease patterns. Even results from a small study population should be paid attention to if the increase in prevalence or incidence of a disease is large. Furthermore, risk-based screening for T2DM and/or prediabetes should be considered in youth at the onset of puberty or ≥10 years of age in overweight and obese youth [15,30,31].
This study has some limitations, including the fact that we could not assess trends before 2002. Our observation period was relatively short and further surveillance will produce better estimates of changes. Another limitation was there were not the adjustment of the individual obesity. Finally, since the NHIS data is billing data, diagnosis information could only be confirmed by disease code. In order to reduce errors, only cases which the diagnosis and drug prescription were simultaneously counted as the patient group. Nevertheless, the strengths of this study were that it included a large national dataset and the fact that it is the first study to date to example the trend in the prevalence of T2DM in children, adolescents, and young adults in Korea.
In conclusion, it should be noted that the prevalence of T2DM in low-income children and adolescents has increased significantly. Given the growing and high prevalence rate of T2DM in Korean younger than 30 years of age, obese children and adolescents at risk of diabetes should educate themselves on the condition and actively undergo screening tests. Research on T2DM in children and adolescents is scarce and conditions for testing are insufficient. It is important to monitor T2DM in children, including via continuous trend analysis. Future studies and collaborations with social support systems to prevent T2DM at an early age group should be performed.
Supplementary materials related to this article can be found online at https://doi.org/10.4093/dmj.2021.0038.
Supplementary Table 1.
The prevalence of T2DM stratified by sex, age, and level of income among Korean children, adolescents, and young adults younger than 30 years of age from 2002 to 2016
dmj-2021-0038-suppl.pdf

CONFLICTS OF INTEREST

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

AUTHOR CONTRIBUTIONS

Conception or design: Y.H.H., S.C.

Acquisition, analysis, or interpretation of data: Y.H.H., I.H.C., K.H., S.C.

Drafting the work or revising: Y.H.H., S.C.

Final approval of the manuscript: Y.H.H., I.H.C., K.H., S.C.

FUNDING

This work was partially supported by the Korean society for the study of obesity, which had not role in study design, data collection, data analysis, data interpretation, or writing of the report. This work was supported by the Soonchunhyang University Research Fund.

Acknowledgements
We thank the Korean National Health Insurance Corporation and all the participants of the study.
Fig. 1.
The prevalence of type 2 diabetes mellitus per 10,000 people among Korean children, adolescents, and young adults younger than 30 years of age from 2002 to 2016. A difference in the slope between male and female is confirmed with the test for trend, P (P=0.015).
dmj-2021-0038f1.jpg
Fig. 2.
The prevalence of type 2 diabetes mellitus per 10,000 people stratified by sex and age among Korean children, adolescents, and young adults younger than 30 years of age from 2002 to 2016. Differences in the slope between groups are confirmed with the test for trend, P. aP for trend <0.05.
dmj-2021-0038f2.jpg
Fig. 3.
The prevalence of type 2 diabetes mellitus per 10,000 people stratified by sex, age, and level of income among Korean children, adolescents, and young adults younger than 30 years of age from 2002 to 2016. Differences in the slope between groups are confirmed with the test for trend, P. Mo, male other (quintile 2–5); ML, male low income (quintile 1); Fo, female other (quintile 2–5); FL, female low income (quintile 1). aP for trend <0.05.
dmj-2021-0038f3.jpg
dmj-2021-0038f4.jpg
Table 1.
The prevalence of T2DM among Korean children, adolescents, and young adults younger than 30 years of age in 2002 and 2016
2002
2016
Fold-increase
No. of diabetes cases General population Prevalence per 10,000 people No. of diabetes cases General population Prevalence per 10,000 people
Total 4,723 20,763,858 2.27 (2.21–2.34) 17,248 17,105,598 10.08 (9.93–10.23) 4.43
Sex
Male 2,773 10,793,738 2.57 (2.49–2.65) 10,202 8,940,797 11.41 (11.19–11.63) 4.44
Female 1,950 9,970,120 1.96 (1.87–2.04) 7,046 8,164,801 8.63 (8.43–8.83) 4.41
Age, yr
0–4 9 2,859,220 0.031 (0.016–0.061) 8 2,245,619 0.036 (0.018–0.071) 1.16
5–9 12 3,419,576 0.035 (0.02–0.062) 47 2,373,633 0.198 (0.15–0.26) 5.65
10–14 144 3,235,613 0.45 (0.38–0.52) 669 2,352,331 2.84 (2.64–3.07) 6.39
15–19 584 3,182,118 1.84 (1.69–1.99) 3,094 3,131,514 9.88 (9.54–10.23) 5.34
20–24 1,007 3,994,329 2.52 (2.37–2.68) 5,248 3,607,915 14.55 (14.16–14.94) 5.76
25–29 2,967 4,073,002 7.29 (7.03–7.55) 8,182 3,394,586 24.10 (23.59–24.63) 3.30

Values are presented as mean (95% confidence interval).

T2DM, type 2 diabetes mellitus.

Table 2.
The prevalence of T2DM among Korean children, adolescents, and young adults younger than 30 years of age from 2002 to 2016
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 P for trend
Total   2.275 2.859 3.179 3.704 4.171 4.327 4.804 5.294 5.528 5.73 5.882 6.503 7.505 8.43 10.083 <0.0001
(2.273–2.276) (2.857–2.861) (3.177–3.181) (3.702–3.707) (4.169–4.173) (4.325–4.329) (4.802–4.807) (5.292–5.297) (5.525–5.530) (5.728–5.732) (5.880–5.884) (6.500–6.505) (7.503–7.507) (8.429–8.432) (10.069–10.098)
Sex
Male 2.57 3.22 3.6 4.15 4.68 4.87 5.36 5.86 6.12 6.48 6.68 7.36 8.44 9.46 11.41 <0.0001
(2.48–2.67) (3.11–3.33) (3.49–3.72) (4.02–4.27) (4.55–4.82) (4.74–5.01) (5.22–5.5) (5.71–6.01) (5.96–6.27) (6.32–6.64) (6.51–6.85) (7.19–7.54) (8.25–8.63) (9.26–9.66) (11.19–11.63)
Female 1.96 2.46 2.72 3.22 3.61 3.74 4.2 4.68 4.88 4.91 5.01 5.57 6.48 7.3 8.63 <0.0001
(1.87–2.04) (2.37–2.57) (2.62–2.82) (3.11–3.34) (3.49–3.74) (3.61–3.86) (4.07–4.33) (4.54–4.82) (4.74–5.03) (4.77–5.06) (4.86–5.16) (5.41–5.73) (6.31–6.66) (7.12–7.49) (8.43–8.83)
Age, yr
0–4 0.031 0.033 0.008 0.017 0.018 0.017 0.013 0.018 0.009 0 0.009 0.009 0.009 0.009 0.036 0.2398
(0.016–0.061) (0.017–0.064) (0.002–0.031) (0.006–0.045) (0.007–0.047) (0.006–0.046) (0.004–0.041) (0.007–0.047) (0.002–0.035) (0.002–0.034) (0.002–0.035) (0.002–0.035) (0.002–0.035) (0.018–0.071)
5–9 0.035 0.066 0.028 0.062 0.08 0.064 0.089 0.143 0.114 0.102 0.106 0.129 0.13 0.141 0.198 <0.0001
(0.02–0.062) (0.043–0.1) (0.014–0.053) (0.04–0.097) (0.054–0.12) (0.041–0.1) (0.06–0.13) (0.1–0.2) (0.079–0.17) (0.069–0.15) (0.072–0.16) (0.09–0.18) (0.091–0.19) (0.1–0.2) (0.15–0.26)
10–14 0.45 0.53 0.58 0.69 0.75 0.93 1.2 1.44 1.47 1.59 1.61 1.84 2.08 2.17 2.84 <0.0001
(0.38–0.52) (0.46–0.62) (0.51–0.67) (0.61–0.78) (0.67–0.85) (0.83–1.03) (1.09–1.32) (1.31–1.57) (1.34–1.61) (1.45–1.73) (1.47–1.76) (1.69–2.01) (1.91–2.26) (1.99–2.36) (2.64–3.07)
15–19 1.84 2.29 2.59 3.23 3.62 3.9 4.15 4.47 4.85 5.08 5.21 5.73 6.83 7.93 9.88 <0.0001
(1.69–1.99) (2.12–2.46) (2.42–2.78) (3.04–3.44) (3.42–3.84) (3.69–4.12) (3.94–4.37) (4.25–4.69) (4.63–5.08) (4.85–5.32) (4.97–5.45) (5.48–5.98) (6.55–7.11) (7.63–8.24) (9.54–10.23)
20–24 2.52 3.42 3.98 5.08 5.94 6.33 6.77 7.55 7.56 7.89 8.23 9.44 10.93 12.28 14.53 <0.0001
(2.37–2.68) (3.24–3.6) (3.78–4.18) (4.85–5.31) (5.69–6.2) (6.07–6.61) (6.49–7.06) (7.26–7.86) (7.26–7.87) (7.59–8.2) (7.93–8.54) (9.13–9.77) (10.59–11.28) (11.92–12.64) (14.16–14.94)
25–29 7.29 9.08 9.89 10.66 11.66 11.42 12.63 13.87 14.75 15.38 15.94 17.24 19.34 21.18 24.1 <0.0001
(7.03–7.55) (8.78–9.38) (9.58–10.21) (10.34–10.98) (11.33–12) (11.1–11.76) (12.29–12.97) (13.51–14.24) (14.37–15.14) (14.98–15.79) (15.52–16.37) (16.8–17.69) (18.87–19.82) (20.69–21.69) (23.59–24.63)

Values are presented as mean (95% confidence interval).

T2DM, type 2 diabetes mellitus.

Table 3.
The prevalence of T2DM stratified by sex, age, and level of income among Korean children, adolescents, and young adults younger than 30 years of age from 2002 to 2016
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 P for trend
10–14 yr
Mo 0.38 0.49 0.58 0.59 0.74 0.80 1.18 1.56 1.54 1.50 1.49 1.58 1.56 1.72 2.51
ML 0.55 0.56 0.35 0.58 0.58 1.44 1.99 2.62 2.56 3.38 2.94 3.08 3.62 3.38 3.18 <0.0001
Fo 0.40 0.52 0.63 0.81 0.80 1.01 1.22 1.30 1.35 1.47 1.30 1.48 1.63 1.45 1.69
FL 0.21 0.23 0.28 0.55 0.89 1.17 1.50 1.74 2.16 1.94 2.03 2.02 2.08 1.75 2.26
15–19 yr
Mo 2.14 2.81 3.01 3.78 3.96 4.79 4.94 5.74 6.89 7.47 7.42 8.48 9.37 10.06 12.43
ML 2.77 3.06 3.64 4.63 6.68 7.40 9.23 11.04 13.08 14.64 16.47 16.31 19.31 21.24 27.05 <0.0001
Fo 1.45 1.60 2.08 2.46 3.03 3.43 4.09 4.43 4.71 4.85 4.38 4.34 5.32 6.35 7.53
FL 0.58 0.70 0.86 1.61 2.55 3.44 4.42 5.18 6.50 6.35 6.86 7.86 9.13 9.77 10.89
20–24 yr
Mo 2.63 3.51 4.07 5.10 5.60 5.98 6.52 7.07 7.07 7.92 9.35 11.49 13.79 17.04 21.40
ML 6.83 7.51 8.43 9.38 10.86 10.73 10.68 11.20 11.93 14.02 15.75 19.31 27.56 36.70 46.34 <0.0001
Fo 2.11 3.15 3.26 3.54 3.34 3.43 3.55 4.43 4.42 4.72 5.49 6.68 7.64 8.46 10.04
FL 2.29 3.40 3.57 5.11 6.09 5.47 5.42 6.88 8.09 9.37 9.95 12.65 15.85 16.98 18.77
25–29 yr
Mo 10.28 11.67 12.86 14.02 14.92 15.22 17.42 19.09 20.08 21.13 22.19 24.50 28.27 32.66 40.56
ML 19.31 23.94 22.46 20.43 23.62 23.62 25.76 27.53 28.52 30.54 30.46 33.16 41.76 49.12 63.14 <0.0001
Fo 6.03 7.47 7.76 8.26 8.79 8.61 9.38 10.01 10.27 10.12 10.53 11.60 13.18 14.96 17.65
FL 5.80 7.28 8.76 10.75 12.38 12.36 14.23 16.58 18.32 18.46 19.92 21.20 23.74 26.24 28.14

Values are presented as mean.

T2DM, type 2 diabetes mellitus; Mo, male other (quintile 2–5); ML, male low income (quintile 1); Fo, female other (quintile 2–5); FL, female low income (quintile 1).

  • 1. Kaufman FR. Type 2 diabetes mellitus in children and youth: a new epidemic. J Pediatr Endocrinol Metab 2002;15 Suppl 2:737-44.ArticlePubMed
  • 2. Jung CH, Son JW, Kang S, Kim WJ, Kim HS, Kim HS, et al. Diabetes fact sheets in Korea, 2020: an appraisal of current status. Diabetes Metab J 2021;45:1-10.ArticlePubMedPMCPDF
  • 3. Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ, Bellary S. Type 2 diabetes in adolescents and young adults. Lancet Diabetes Endocrinol 2018;6:69-80.ArticlePubMed
  • 4. Gungor N, Arslanian S. Progressive beta cell failure in type 2 diabetes mellitus of youth. J Pediatr 2004;144:656-9.ArticlePubMed
  • 5. Nadeau KJ, Anderson BJ, Berg EG, Chiang JL, Chou H, Copeland KC, et al. Youth-onset type 2 diabetes consensus report: current status, challenges, and priorities. Diabetes Care 2016;39:1635-42.ArticlePubMedPMCPDF
  • 6. Magliano DJ, Sacre JW, Harding JL, Gregg EW, Zimmet PZ, Shaw JE. Young-onset type 2 diabetes mellitus: implications for morbidity and mortality. Nat Rev Endocrinol 2020;16:321-31.ArticlePubMedPDF
  • 7. Sattar N, Rawshani A, Franzen S, Rawshani A, Svensson AM, Rosengren A, et al. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks. Circulation 2019;139:2228-37.ArticlePubMed
  • 8. Rhodes ET, Prosser LA, Hoerger TJ, Lieu T, Ludwig DS, Laffel LM. Estimated morbidity and mortality in adolescents and young adults diagnosed with type 2 diabetes mellitus. Diabet Med 2012;29:453-63.ArticlePubMedPDF
  • 9. Fazeli Farsani S, van der Aa MP, van der Vorst MM, Knibbe CA, de Boer A. Global trends in the incidence and prevalence of type 2 diabetes in children and adolescents: a systematic review and evaluation of methodological approaches. Diabetologia 2013;56:1471-88.ArticlePubMedPDF
  • 10. Alberti G, Zimmet P, Shaw J, Bloomgarden Z, Kaufman F, Silink M, et al. Type 2 diabetes in the young: the evolving epidemic: the international diabetes federation consensus workshop. Diabetes Care 2004;27:1798-811.PubMed
  • 11. Dabelea D, Mayer-Davis EJ, Saydah S, Imperatore G, Linder B, Divers J, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA 2014;311:1778-86.ArticlePubMedPMC
  • 12. Cockram CS. The epidemiology of diabetes mellitus in the Asia-Pacific region. Hong Kong Med J 2000;6:43-52.PubMed
  • 13. Chi X, Yu D, Ju L, Zhang J, Zhao L. Prevalence of diabetes and change among 7 to 17 years old children and adolescents in China in 2002-2012. Wei Sheng Yan Jiu 2018;47:705-15.PubMed
  • 14. Fu JF, Liang L, Gong CX, Xiong F, Luo FH, Liu GL, et al. Status and trends of diabetes in Chinese children: analysis of data from 14 medical centers. World J Pediatr 2013;9:127-34.ArticlePubMedPDF
  • 15. Hannon TS, Janosky J, Arslanian SA. Longitudinal study of physiologic insulin resistance and metabolic changes of puberty. Pediatr Res 2006;60:759-63.ArticlePubMed
  • 16. Zeitler P, Arslanian S, Fu J, Pinhas-Hamiel O, Reinehr T, Tandon N, et al. ISPAD clinical practice consensus guidelines 2018: type 2 diabetes mellitus in youth. Pediatr Diabetes 2018;19 Suppl 27:28-46.ArticlePubMedPDF
  • 17. Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J, Isom S, Dolan L, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012. N Engl J Med 2017;376:1419-29.ArticlePubMedPMC
  • 18. Nam HK, Kim HR, Rhie YJ, Lee KH. Trends in the prevalence of extreme obesity among Korean children and adolescents from 2001 to 2014. J Pediatr Endocrinol Metab 2017;30:517-23.ArticlePubMed
  • 19. McGavock J, Wicklow B, Dart AB. Type 2 diabetes in youth is a disease of poverty. Lancet 2017;390:1829.Article
  • 20. Dabelea D, Stafford JM, Mayer-Davis EJ, D’Agostino R Jr, Dolan L, Imperatore G, et al. Association of type 1 diabetes vs type 2 diabetes diagnosed during childhood and adolescence with complications during teenage years and young adulthood. JAMA 2017;317:825-35.ArticlePubMedPMC
  • 21. Copeland KC, Zeitler P, Geffner M, Guandalini C, Higgins J, Hirst K, et al. Characteristics of adolescents and youth with recent-onset type 2 diabetes: the TODAY cohort at baseline. J Clin Endocrinol Metab 2011;96:159-67.ArticlePubMed
  • 22. Klingensmith GJ, Tamborlane WV, Wood J, Haller MJ, Silverstein J, Cengiz E, et al. Diabetic ketoacidosis at diabetes onset: still an all too common threat in youth. J Pediatr 2013;162:330-4.ArticlePubMed
  • 23. Klingensmith GJ, Connor CG, Ruedy KJ, Beck RW, Kollman C, Haro H, et al. Presentation of youth with type 2 diabetes in the Pediatric Diabetes Consortium. Pediatr Diabetes 2016;17:266-73.ArticlePubMed
  • 24. Kim NH, Kim TJ, Kim NH, Choi KM, Baik SH, Choi DS, et al. Relative and combined effects of socioeconomic status and diabetes on mortality: a nationwide cohort study. Medicine (Baltimore) 2016;95:e4403.PubMedPMC
  • 25. Noh J, Han KD, Ko SH, Ko KS, Park CY. Trends in the pervasiveness of type 2 diabetes, impaired fasting glucose and comorbidities during an 8-year-follow-up of nationwide Korean population. Sci Rep 2017;7:46656.ArticlePubMedPMCPDF
  • 26. Park YS, Lee DH, Choi JM, Kang YJ, Kim CH. Trend of obesity in school age children in Seoul over the past 23 years. Korean J Pediatr 2004;47:247-57.
  • 27. Pediatric Obesity Committee of Korean Society for the Study of Obesity. Obesity in children and adolescents. 3rd ed. Seoul: Chung Woon; 2019. p. 2.
  • 28. Kim JH, Moon JS. Secular trends in pediatric overweight and obesity in Korea. J Obes Metab Syndr 2020;29:12-7.ArticlePubMedPMC
  • 29. Nam GE, Kim YH, Han K, Jung JH, Rhee EJ, Lee SS, et al. Obesity fact sheet in Korea, 2019: prevalence of obesity and abdominal obesity from 2009 to 2018 and social factors. J Obes Metab Syndr 2020;29:124-32.ArticlePubMedPMC
  • 30. Arslanian S, Bacha F, Grey M, Marcus MD, White NH, Zeitler P. Evaluation and management of youth-onset type 2 diabetes: a position statement by the American Diabetes Association. Diabetes Care 2018;41:2648-68.ArticlePubMedPMCPDF
  • 31. Brar PC. Update on the current modalities used to screen high risk youth for prediabetes and/or type 2 diabetes mellitus. Ann Pediatr Endocrinol Metab 2019;24:71-7.ArticlePubMedPMCPDF

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • SCORE and SCORE2 in East Asian Population
      JungMin Choi, Soseul Sung, Sue K. Park, Seyong Park, Hyoyeong Kim, Myeong-Chan Cho, Bryan Williams, Hae-Young Lee
      JACC: Asia.2024; 4(4): 265.     CrossRef
    • Characteristics and management of juvenile type 2 diabetes mellitus
      Young-Jun Rhie
      Journal of the Korean Medical Association.2024; 67(5): 342.     CrossRef
    • Suggestions for the management of pediatric obesity in Korea
      Yong Hee Hong
      Journal of the Korean Medical Association.2024; 67(5): 306.     CrossRef
    • Chronic disease management program applied to type 2 diabetes patients and prevention of diabetic complications: a retrospective cohort study using nationwide data
      Min Kyung Hyun, Jang Won Lee, Seung-Hyun Ko
      BMC Public Health.2023;[Epub]     CrossRef
    • Clinical and pathological characteristics of DKD patients with early-onset type 2 diabetes
      Liang Wu, Yi-Yang Zhao, Meng-Rui Li, Dong-Yuan Chang, Ming-Hui Zhao, Min Chen
      Journal of Diabetes and its Complications.2023; 37(8): 108520.     CrossRef
    • Type 2 Diabetes and Its Association With Psychiatric Disorders in Young Adults in South Korea
      Min-Kyung Lee, Su-Young Lee, Seo-Young Sohn, Jiyeon Ahn, Kyungdo Han, Jae-Hyuk Lee
      JAMA Network Open.2023; 6(6): e2319132.     CrossRef
    • Glycemic control and complications of type 2 diabetes mellitus in children and adolescents during the COVID-19 outbreak
      Kyeong Eun Oh, Yu Jin Kim, Ye Rim Oh, Eungu Kang, Hyo-Kyoung Nam, Young-Jun Rhie, Kee-Hyoung Lee
      Annals of Pediatric Endocrinology & Metabolism.2023; 28(4): 275.     CrossRef
    • Position Statement on the Appropriateness and Significance of Adding the Glycated Hemoglobin Test to the National Health Examination
      Ji Hye Kim, Dae Jung Kim, Jaehyun Kim, Sangjoon Park, Kyunghoon Lee, Jun Goo Kang, Eu Jeong Ku, Su Kyoung Kwon, Won Jun Kim, Young Sang Lyu, Jang Won Son, Young Sil Eom, Kyung Ae Lee, Jeongrim Lee, Jung Min Lee, Jung Hwa Lee, Jung Hwa Jung, Hochan Cho, Da
      The Journal of Korean Diabetes.2023; 24(4): 178.     CrossRef
    • Trends and Risk Factors of Metabolic Syndrome among Korean Adolescents, 2007 to 2018 (Diabetes Metab J 2021;45:880-9)
      Dae Jung Kim
      Diabetes & Metabolism Journal.2022; 46(2): 349.     CrossRef
    • Prevalence trends of type 1 and type 2 diabetes in children and adolescents in North Rhine-Westphalia, the most populous federal state in Germany, 2002-2020
      C. Baechle, A. Stahl-Pehe, N. Prinz, T. Meissner, C. Kamrath, R.W. Holl, J. Rosenbauer
      Diabetes Research and Clinical Practice.2022; 190: 109995.     CrossRef
    • Diagnostic and Therapeutic Strategies of Type 2 Diabetes Mellitus in Youth
      Hwa Young Kim, Jae Hyun Kim
      The Ewha Medical Journal.2022;[Epub]     CrossRef
    • Factors Affecting High-Risk for Diabetes among Korean Adolescents: An Analysis Using the Eighth Korea National Health and Nutrition Examination Survey (2020)
      Kyung-Sook Bang, Sang-Youn Jang, Ji-Hye Choe
      Children.2022; 9(8): 1249.     CrossRef
    • Characteristics of Glycemic Control and Long-Term Complications in Patients with Young-Onset Type 2 Diabetes
      Han-sang Baek, Ji-Yeon Park, Jin Yu, Joonyub Lee, Yeoree Yang, Jeonghoon Ha, Seung Hwan Lee, Jae Hyoung Cho, Dong-Jun Lim, Hun-Sung Kim
      Endocrinology and Metabolism.2022; 37(4): 641.     CrossRef
    • 젊은 2형 당뇨병 환자의 관리
      재현 배
      Public Health Weekly Report.2022; 15(35): 2474.     CrossRef

    • PubReader PubReader
    • ePub LinkePub Link
    • Cite
      CITE
      export Copy
      Close
      Download Citation
      Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

      Format:
      • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
      • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
      Include:
      • Citation for the content below
      Prevalence of Type 2 Diabetes Mellitus among Korean Children, Adolescents, and Adults Younger than 30 Years: Changes from 2002 to 2016
      Diabetes Metab J. 2022;46(2):297-306.   Published online October 26, 2021
      Close
    • XML DownloadXML Download
    Figure

    Diabetes Metab J : Diabetes & Metabolism Journal