J Korean Med Sci.  2010 Dec;25(12):1777-1783. 10.3346/jkms.2010.25.12.1777.

Type 2 Diabetes in Urban and Rural Districts in Korea: Factors Associated with Prevalence Difference

• Lee HY
• Won JC
• Kang YJ
• Yoon SH
• Choi EO
• Bae JY
• Sung MH
• Kim HR
• Yang JH
• Oh J
• Lee YM
• Park NH
• Ko KS
• Rhee BD

• KMID: 1792903
• DOI: http://doi.org/10.3346/jkms.2010.25.12.1777

Abstract

The purpose of this study was to examine the urban-rural differences in the prevalence and associated factors with type 2 diabetes mellitus (T2DM) in Korean adults. A total of 1,060 adults >30 yr of age from urban (189 males and 331 females) and rural districts (219 males and 321 females) were recruited. Anthropometric measures, blood pressure, lipid profiles, and fasting and 2-hr after 75-g oral glucose load blood glucose were obtained. The crude- and age-standardized prevalence of T2DM was 15.4% and 14.5%, and 11.7% and 8.6% in urban and rural districts, respectively. Diabetic subjects were older and obese, and had a higher triglyceride level, and systolic blood pressure compared to non-diabetes in both population. Multivariate regression analysis revealed that older age, high triglyceride levels, central obesity, and hypertension were significantly associated with T2DM in both areas. Low monthly incomes were significantly associated with T2DM in urban population, while a family history of T2DM was significantly associated with T2DM in rural area. T2DM is more prevalent in urban than in rural population, and low economic status or genetic factor is differently associated with T2DM in both population, respectively.

Keyword

Diabetes; Prevalence; Urban; Rural

MeSH Terms

Adult
Age Factors
Aged
Diabetes Mellitus, Type 2/complications/*epidemiology
Female
Humans
Hypertension/complications
Male
Middle Aged
Obesity/complications
Prevalence
Regression Analysis
Republic of Korea/epidemiology
Risk Factors
Rural Population
Socioeconomic Factors
Triglycerides/blood
Urban Population

Figure

• 

  Fig. 1 Age- and gender-standardized prevalence of type 2 diabetes. *Prevalence rates were standardized to the age- and sex-distribution of the Korean population in 2005.

Reference

1. Ko M, Kim MT, Nam JJ. Assessing risk factors of coronary heart disease and its risk prediction among Korean adults: the 2001 Korea National Health and Nutrition Examination Survey. Int J Cardiol. 2006. 110:184–190.

2. Roglic G, Unwin N, Bennett PH, Mathers C, Tuomilehto J, Nag S, Connolly V, King H. The burden of mortality attributable to diabetes: realistic estimates for the year 2000. Diabetes Care. 2005. 28:2130–2135.

3. Cho M, Park JS, Nam J, Kim CS, Nam JH, Kim HJ, Ahn CW, Cha BS, Lim SK, Kim KR, Lee HC, Huh KB. Association of Abdominal Obesity with Atherosclerosis in Type 2 Diabetes Mellitus (T2DM) in Korea. J Korean Med Sci. 2008. 23:781–788.

4. King H, Rewers M. WHO Ad Hoc Diabetes Reporting Group. Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. Diabetes Care. 1993. 16:157–177.

5. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998. 21:1414–1431.

6. 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.

7. Kim SM, Lee JS, Lee J, Na JK, Han JH, Yoon DK, Baik SH, Choi DS, Choi KM. Prevalence of diabetes and impaired fasting glucose in Korea: Korean National Health and Nutrition Survey 2001. Diabetes Care. 2006. 29:226–231.

8. Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001. 414:782–787.

9. IDF Clinical Guidelines Task Force. Global Guideline for Type 2 Diabetes: recommendations for standard, comprehensive, and minimal care. Diabet Med. 2006. 23:579–593.

10. Choi YJ, Kim HC, Kim HM, Park SW, Kim J, Kim DJ. Prevalence and management of diabetes in Korean adults: Korea National Health and Nutrition Examination Surveys 1998-2005. Diabetes Care. 2009. 32:2016–2020.

11. Choi YJ, Cho YM, Park CK, Jang HC, Park KS, Kim SY, Lee HK. Rapidly increasing diabetes-related mortality with socio-environmental changes in South Korea during the last two decades. Diabetes Res Clin Pract. 2006. 74:295–300.

12. Park KS. Prevention of type 2 diabetes mellitus from the viewpoint of genetics. Diabetes Res Clin Pract. 2004. 66:Suppl 1. S33–S35.

13. Song KH, Nam-Goomg IS, Han SM, Kim MS, Lee EJ, Lee YS, Lee MS, Yoon S, Lee KU, Park JY. Change in prevalence and 6-year incidence of diabetes and impaired fasting glucose in Korean subjects living in a rural area. Diabetes Res Clin Pract. 2007. 78:378–384.

14. Qiao Q, Hu G, Tuomilehto J, Nakagami T, Balkau B, Borch-Johnsen K, Ramachandran A, Mohan V, Iyer SR, Tominaga M, Kiyohara Y, Kato I, Okubo K, Nagai M, Shibazaki S, Yang Z, Tong Z, Fan Q, Wang B, Chew SK, Tan BY, Heng D, Emmanuel S, Tajima N, Iwamoto Y, Snehalatha C, Vijay V, Kapur A, Dong Y, Nan H, Gao W, Shi H, Fu F. DECODA Study Group. Age- and sex-specific prevalence of diabetes and impaired glucose regulation in 11 Asian cohorts. Diabetes Care. 2003. 26:1770–1780.

15. McNeely MJ, Boyko EJ. Type 2 diabetes prevalence in Asian Americans: results of a national health survey. Diabetes Care. 2004. 27:66–69.

16. Singh GK, Hiatt RA. Trends and disparities in socioeconomic and behavioural characteristics, life expectancy, and cause-specific mortality of native-born and foreign-born populations in the United States, 1979-2003. Int J Epidemiol. 2006. 35:903–919.

17. Ramachandran A, Snehalatha C, Dharmaraj D, Viswanathan M. Prevalence of glucose intolerance in Asian Indians. Urban-rural difference and significance of upper body adiposity. Diabetes Care. 1992. 15:1348–1355.

18. Heikes KE, Eddy DM, Arondekar B, Schlessinger L. Diabetes Risk Calculator: a simple tool for detecting undiagnosed diabetes and pre-diabetes. Diabetes Care. 2008. 31:1040–1045.

19. 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.

20. Park JY, Kim YI, Choi CS, Chung YE, Kim SW, Lee MS, Lee SI, Hong SK, Lee KU. Prevalence of diabetes, impaired glucose tolerance, and impaired fasting glucose in a rural population of Korea, according to 1997 American Diabetes Association and 1985 World Health Organization criteria. Diabetes Care. 2000. 23:707–708.

21. Sekikawa A, Eguchi H, Tominaga M, Igarashi K, Abe T, Manaka H, Sasaki H, Fukuyama H, Kato T, Kiyohara Y, Fujishima M. Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in a rural area of Japan. The Funagata diabetes study. J Diabetes Complications. 2000. 14:78–83.

22. Sone H, Mizuno S, Ohashi Y, Yamada N. Type 2 diabetes prevalence in Asian subjects. Diabetes Care. 2004. 27:1251–1252.

23. McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991. 337:382–386.

24. Schmidt MI, Duncan BB, Bang H, Pankow JS, Ballantyne CM, Golden SH, Folsom AR, Chambless LE. Atherosclerosis Risk in Communities Investigators. Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. Diabetes Care. 2005. 28:2013–2018.

25. Ramachandran A, Snehalatha C, Baskar AD, Mary S, Kumar CK, Selvam S, Catherine S, Vijay V. Temporal changes in prevalence of diabetes and impaired glucose tolerance associated with lifestyle transition occurring in the rural population in India. Diabetologia. 2004. 47:860–865.

26. McDermott R, Rowley KG, Lee AJ, Knight S, O'Dea K. Increase in prevalence of obesity and diabetes and decrease in plasma cholesterol in a central Australian aboriginal community. Med J Aust. 2000. 172:480–484.

27. Dunstan DW, Zimmet PZ, Welborn TA, De Courten MP, Cameron AJ, Sicree RA, Dwyer T, Colagiuri S, Jolley D, Knuiman M, Atkins R, Shaw JE. The rising prevalence of diabetes and impaired glucose tolerance: the Australian Diabetes, Obesity and Lifestyle Study. Diabetes Care. 2002. 25:829–834.

28. Vijayakumar G, Arun R, Kutty VR. High prevalence of type 2 diabetes mellitus and other metabolic disorders in rural Central Kerala. J Assoc Physicians India. 2009. 57:563–567.

29. Guize L, Jaffiol C, Guéniot M, Bringer J, Giudicelli C, Tramoni M, Thomas F, Pannier B, Bean K, Jego B. Diabetes and socio-economic deprivation. A study in a large French population. Bull Acad Natl Med. 2008. 192:1707–1723.