J Korean Acad Nurs.  2014 Dec;44(6):743-750. 10.4040/jkan.2014.44.6.743.

Trend Analysis in the Prevalence of Type 2 Diabetes According to Risk Factors among Korean Adults: Based on the 2001~2009 Korean National Health and Nutrition Examination Survey Data

• Kim YJ
• Lim MN
• Lee DS

• KMID: 2129565
• DOI: http://doi.org/10.4040/jkan.2014.44.6.743

Abstract

PURPOSE
The objective of this study was to provide a trend analysis of the prevalence of diabetes relative to the socioeconomic, lifestyle, and physiologic risk factors among Korean adults aged over 30 years for a 10-year period using data from the Korean National Health and Nutrition Examination Survey.
METHODS
Prevalence difference and the slope index of inequality were calculated for each risk factors using binomial regression by considering the repeated cross-sectional features of the data. The prevalence ratio and the relative index of inequality were calculated using log-binomial regression. Linear trend tests were performed using SAS 9.2.
RESULTS
Crude prevalence of diabetes increased over the 10-year period, and was higher for men than for women. It was very high for adults 60 years or over, consistently increasing over time. The prevalence among unemployed men, women with higher level of stress, women with hypertension, and adults with serum triglyceride levels over 135 mg/dL increased over the 10-year period in comparison with the respective control group.
CONCLUSION
Considering the rapid economic development and associated lifestyle changes in Korea, action should be taken to control the prevalence of diabetes by both preventing and consistently monitoring these identified risk factors using a public-health approach.

Keyword

Type 2 diabetes mellitus; Prevalence; Trends; Risk factors

MeSH Terms

Adult
Aged
Alcohol Drinking
Asian Continental Ancestry Group
Body Mass Index
Cholesterol/blood
Cross-Sectional Studies
Diabetes Mellitus, Type 2/*epidemiology/pathology
Exercise
Female
Humans
Hypertension/epidemiology
Life Style
Male
Middle Aged
Nutrition Surveys
Prevalence
Republic of Korea
Risk Factors
Smoking
Socioeconomic Factors
Stress, Psychological
Triglycerides/blood
Unemployment
Cholesterol
Triglycerides

Reference

1. Gupta R, Kumar P. Global diabetes landscape-type 2 diabetes mellitus in South Asia: Epidemiology, risk factors, and control. Insulin. 2008; 3(2):78–94. http://dx.doi.org/10.1016/S1557-0843(08)80019-X.

2. Statistics Korea. 2011 cause of death[Internet]. Daejeon: Author;2012. cited 2012 September 30. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=260046.

3. Park SW, Kim DJ, Min KW, Baik SH, Choi KM, Park IB, et al. Current status of diabetes management in Korea using national health insurance database. J Korean Diabetes Assoc. 2007; 31(4):362–367. http://dx.doi.org/10.4093/jkda.2007.31.4.362.

4. Ministry of Health & Welfare and Family Affairs, Korea Center for Disease Control & Prevention. Korea health statistics 2005: Korea national health and nutrition examination survey (KNHANES III). Seoul: Korea Center for Disease Control & Prevention;2006.

5. Kim SG, Choi DS. The present state of diabetes mellitus in Korea. J Korean Med Assoc. 2008; 51(9):791–798. http://dx.doi.org/10.5124/jkma.2008.51.9.791.

6. Imkampe AK, Gulliford MC. Increasing socio-economic inequality in type 2 diabetes prevalence-repeated cross-sectional surveys in England 1994-2006. Eur J Public Health. 2011; 21(4):484–490. http://dx.doi.org/10.1093/eurpub/ckq106.

7. Krishnan S, Cozier YC, Rosenberg L, Palmer JR. Socioeconomic status and incidence of type 2 diabetes: Results from the black women's health study. Am J Epidemiol. 2010; 171(5):564–570. http://dx.doi.org/10.1093/aje/kwp443.

8. Zisser H, Sueyoshi M, Krigstein K, Szigiato A, Riddell MC. Advances in exercise, physical activity and diabetes mellitus. Int J Clin Pract Suppl. 2012; 66:Suppl 175. 62–71. http://dx.doi.org/10.1111/j.1742-1241.2011.02856.x.

9. Norberg M, Stenlund H, Lindahl B, Andersson C, Eriksson JW, Weinehall L. Work stress and low emotional support is associated with increased risk of future type 2 diabetes in women. Diabetes Res Clin Pract. 2007; 76(3):368–377. http://dx.doi.org/10.1016/j.diabres.2006.09.002.

10. Kim DH, Ahn YO, Park SW, Choi MG, Kim DS, Lee MS, et al. Incidence and risk factors for diabetes mellitus in Korean middle-aged men: Seoul cohort DM follow-up study. Korean J Prev Med. 1999; 32(4):526–537.

11. Perry IJ, Wannamethee SG, Walker MK, Thomson AG, Whincup PH, Shaper AG. Prospective study of risk factors for development of noninsulin dependent diabetes in middle aged British men. BMJ. 1995; 310(6979):560–564.

12. Dotevall A, Johansson S, Wilhelmsen L, Rosengren A. Increased levels of triglycerides, BMI and blood pressure and low physical activity increase the risk of diabetes in Swedish women. A prospective 18-year follow-up of the BEDA study. Diabet Med. 2004; 21(6):615–622. http://dx.doi.org/10.1111/j.1464-5491.2004.01189.x.

13. Lee JW, Brancati FL, Yeh HC. Trends in the prevalence of type 2 diabetes in Asians versus whites: Results from the United States national health interview survey, 1997-2008. Diabetes Care. 2011; 34(2):353–357. http://dx.doi.org/10.2337/dc10-0746.

14. Mokdad AH, Ford ES, Bowman BA, Nelson DE, Engelgau MM, Vinicor F, et al. Diabetes trends in the U.S.: 1990-1998. Diabetes Care. 2000; 23(9):1278–1283.

15. Heidemann C, Kroll L, Icks A, Lampert T, Scheidt-Nave C. Prevalence of known diabetes in German adults aged 25-69 years: Results from national health surveys over 15 years. Diabet Med. 2009; 26(6):655–658. http://dx.doi.org/10.1111/j.1464-5491.2009.02739.x.

16. Hamer M, Kengne AP, Batty GD, Cooke D, Stamatakis E. Temporal trends in diabetes prevalence and key diabetes risk factors in Scotland, 2003-2008. Diabet Med. 2011; 28(5):595–598.

17. Ministry of Health & Welfare, Korea Centers for Disease Control & Prevention. Korea health statistics 2009: Korea national health and nutrition examination survey (KNHANES IV-3). Seoul: Ministry of Health & Welfare;2010.

18. Yoo S, Cho HJ, Khang YH. General and abdominal obesity in South Korea, 1998-2007: Gender and socioeconomic differences. Prev Med. 2010; 51(6):460–465. http://dx.doi.org/10.1016/j.ypmed.2010.10.004.

19. Khang YH, Yun SC, Lynch JW. Monitoring trends in socioeconomic health inequalities: It matters how you measure. BMC Public Health. 2008; 8:66. http://dx.doi.org/10.1186/1471-2458-8-66.

20. Ernstsen L, Strand BH, Nilsen SM, Espnes GA, Krokstad S. Trends in absolute and relative educational inequalities in four modifiable ischaemic heart disease risk factors: Repeated cross-sectional surveys from the Nord-trondelag health study (HUNT) 1984-2008. BMC Public Health. 2012; 12:266. http://dx.doi.org/10.1186/1471-2458-12-266.

21. Ministry of Health & Welfare, Korea Centers for Disease Control & Prevention. Korea health statistics 2011: Korea national health and nutrition examination survey (KNHANES V-2)[Internet]. Seoul: Ministry of Health & Welfare;2012.

22. International Diabetes Federation. Diabetes atlas. 5th ed. Brussels, BE: Author;2011.

23. Diamond J. The double puzzle of diabetes. Nature. 2003; 423(6940):599–602. http://dx.doi.org/10.1038/423599a.

24. Statistics Korea. Elderly statistics 2010. Daejeon: Author;2010.

25. Wong K, Glovaci D, Malik S, Franklin SS, Wygant G, Iloeje U, et al. Comparison of demographic factors and cardiovascular risk factor control among U.S. adults with type 2 diabetes by insulin treatment classification. J Diabetes Complications. 2012; 26(3):169–174. http://dx.doi.org/10.1016/j.jdiacomp.2012.03.006.

26. Franzini L, Ardigò D, Cavalot F, Miccoli R, Rivellese AA, Trovati M, et al. Women show worse control of type 2 diabetes and cardiovascular disease risk factors than men: Results from the MIND.IT study group of the Italian society of diabetology. Nutr Metab Cardiovasc Dis. 2013; 23(3):235–241. http://dx.doi.org/10.1016/j.numecd.2011.12.003.

27. Go MJ. Establishing a prediction model for type 2 diabetes risk using the epidemiological and genetic risk factors. Public Health Wkly Rep. 2011; 4(34):605–608.

28. Ku BJ. Source of diabetes insulin resistance. Seoul: Nutradex;2001.

29. Ma RC, Chan JC. Type 2 diabetes in East Asians: Similarities and differences with populations in Europe and the United States. Ann N Y Acad Sci. 2013; 1281:64–91. http://dx.doi.org/10.1111/nyas.12098.

30. Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al. Diabetes in Asia: Epidemiology, risk factors, and pathophysiology. JAMA. 2009; 301(20):2129–2140. http://dx.doi.org/10.1001/jama.2009.726.