J Korean Med Sci.  2013 Jun;28(6):814-820. 10.3346/jkms.2013.28.6.814.

Factors Associated with Diabetic Retinopathy and Nephropathy Screening in Korea: The Third and Fourth Korea National Health and Nutrition Examination Survey (KNHANES III and IV)

Affiliations
  • 1Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. yoonjs@yuhs.ac
  • 2Department of Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Abstract

This cross-sectional study was done to identify and determine the socio-demographic and health-related factors associated with diabetic retinopathy and nephropathy screening in Korea. Participants included 2,660 adults, aged 40 or older, with diabetes. Of the 2,660 adults, 998 (37%) and 1,226 (46.1%) had received a diabetic retinopathy and a nephropathy screening within one year, respectively. Regarding retinopathy, subjects older than 65, living in urban areas, with high educational levels, and with self-reported "unhealthy" status were likely to receive annual screening. Subjects living in urban areas, with higher educational levels, with self-reported "fair" or "unhealthy" status, and with 1 to 2 co-morbidities were likely to receive annual nephropathy screening. The Korea Composite Stock Price Index (KOSPI) continued to rise until 2007 when it started to decline over the subsequent years, following the same curve as the diabetic retinopathy and nephropathy screening rates during that time. Together with the financial matter, lack of patient education proved to be a hindrance to diabetes-related screening. The relatively low screening rates in Korea compared to the Western countries are likely to be due to the difference in the health system, economic situations and national demographics.

Keyword

Diabetes Complications; Diabetic Nephropathy; Diabetic Retinopathy; Economic Crisis; Diabetes Care; KNHANES

MeSH Terms

Adult
Aged
Cross-Sectional Studies
Diabetes Complications/pathology
Diabetes Mellitus/diagnosis
Diabetic Nephropathies/diagnosis/*etiology
Diabetic Retinopathy/diagnosis/*etiology
Female
Health Behavior
Health Status
Humans
Male
Mass Screening
Middle Aged
Nutrition Surveys
Odds Ratio
Republic of Korea
Risk Factors
Severity of Illness Index

Figure

  • Fig. 1 Flow diagrams showing selection of the study population.

  • Fig. 2 Screening rates of diabetic retinopathy and nephropathy. (A) Diabetic retinopathy screening rates are 38.1% (SE 5.5) in Korea National Health and Nutrition Examination Survey 2005 (KNHANES III) and 36.9% (SE 5.8) in KNHANES IV. Diabetic nephropathy screening rates are 50.4% (SE 5.3) in KNHANES III and 41.2% (SE 5.8) in KNHANES IV. (B) The averages of diabetic retinopathy screening rates were 38.1% (SE 5.5) in 2005, 41.7% (SE 14.2) in 2007, 35.2% (SE 9.4) in 2008, and 36.7% (SE 8.8) in 2009. In terms of diabetic nephropathy screening, the rates were 42.9% (SE 14.4) in 2007, 38.3% (SE 9.3), and 43.2% (SE 8.6) in 2009. The Korea Composite Stock Price Index (KOSPI) goes parallel with the diabetic retinopathy and nephropathy screening rates. (C) The averages of diabetic retinopathy screening rates in the United States were 54.8 in 2005, 54.6 in 2006, 55.0 in 2007, 56.5 in 2008, and 56.5 in 2009. The averages of diabetic nephropathy screening rates were 55.1 in 2005, 79.7 in 2006, 80.6 in 2007, 82.4 in 2008, and 82.9 in 2009. The Dow Jones Industrial Average (DJIA) decreased after 2007, but both diabetic retinopathy and nephropathy screening rates gradually increased.


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