Diabetes Metab J.  2018 Oct;42(5):415-424. 10.4093/dmj.2018.0017.

Diabetes Fact Sheet in Korea, 2016: An Appraisal of Current Status

• Won JC
• Lee JH
• Kim JH
• Kang ES
• Won KC
• Kim DJ
• Lee MK

• KMID: 2422786
• DOI: http://doi.org/10.4093/dmj.2018.0017

Abstract

BACKGROUND
This report presents the recent prevalence and comorbidities related to diabetes in Korea by analyzing the nationally representative data.
METHODS
Using data from the Korea National Health and Nutrition Examination Survey for 2013 to 2014, the percentages and the total number of subjects over the age of 30 years with diabetes and prediabetes were estimated and applied to the National Population Census in 2014. Diagnosis of diabetes was based on fasting plasma glucose (≥126 mg/dL), current taking of antidiabetic medication, history of previous diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%. Impaired fasting glucose (IFG) was defined by fasting plasma glucose in the range of 100 to 125 mg/dL among those without diabetes.
RESULTS
About 4.8 million (13.7%) Korean adults (≥30 years old) had diabetes, and about 8.3 million (24.8%) Korean adults had IFG. However, 29.3% of the subjects with diabetes are not aware of their condition. Of the subjects with diabetes, 48.6% and 54.7% were obese and hypertensive, respectively, and 31.6% had hypercholesterolemia. Although most subjects with diabetes (89.1%) were under medical treatment, and mostly being treated with oral hypoglycemic agents (80.2%), 10.8% have remained untreated. With respect to overall glycemic control, 43.5% reached the target of HbA1c < 7%, whereas 23.3% reached the target when the standard was set to HbA1c < 6.5%, according to the Korean Diabetes Association guideline.
CONCLUSION
Diabetes is a major public health threat in Korea, but a significant proportion of adults were not controlling their illness. We need comprehensive approaches to overcome the upcoming diabetes-related disease burden in Korea.

Keyword

Comorbidity; Diabetes mellitus; Glycated hemoglobin A; Prediabetic state; Prevalence; Public health; Republic of Korea

MeSH Terms

Adult
Blood Glucose
Censuses
Comorbidity
Diabetes Mellitus
Diagnosis
Fasting
Glucose
Hemoglobin A, Glycosylated
Humans
Hypercholesterolemia
Hypoglycemic Agents
Korea*
Nutrition Surveys
Prediabetic State
Prevalence
Public Health
Republic of Korea
Glucose
Hypoglycemic Agents

Figure

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  Fig. 1 Estimated proportion of adults (≥30 years old) with diabetes according to body mass index (kg/m2) (A) and abdominal obesity (B). Abdominal obesity is defined by abdominal circumferences ≥90 cm in men and ≥85 cm in women.

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  Fig. 2 Estimated proportion of adults (≥30 years old) with diabetes according to type of treatment for hyperglycemia (A) and glycosylated hemoglobin (HbA1c) (%) (B). OHA, oral hypoglycemic agent; TLC, therapeutic life style.

Reference

1. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, Cavan D, Shaw JE, Makaroff LE. IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract. 2017; 128:40–50. PMID: 28437734.

2. Shin HY, Lee JY, Song J, Lee S, Lee J, Lim B, Kim H, Huh S. Cause-of-death statistics in the Republic of Korea, 2014. J Korean Med Assoc. 2016; 59:221–232.

3. Yoon J, Seo H, Oh IH, Yoon SJ. The non-communicable disease burden in Korea: findings from the 2012 Korean Burden of Disease Study. J Korean Med Sci. 2016; 31(Suppl 2):S158–S167. PMID: 27775253.

4. Choi YJ, Lee MS, An SY, Kim TH, Han SJ, Kim HJ, Chung YS, Lee KW, Kim DJ. The relationship between diabetes mellitus and health-related quality of life in Korean adults: the fourth Korea National Health and Nutrition Examination Survey (2007-2009). Diabetes Metab J. 2011; 35:587–594. PMID: 22247901.

5. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18:499–502. PMID: 4337382.

6. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014; 37(Suppl 1):S81–S90. PMID: 24357215.

7. Bassett J. International Diabetes Institute. World Health Organization Regional Office for the Western Pacific. International Association for the Study of Obesity. International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia;2000.

8. Oh SW, Shin SA, Yun YH, Yoo T, Huh BY. Cut-off point of BMI and obesity-related comorbidities and mortality in middle-aged Koreans. Obes Res. 2004; 12:2031–2040. PMID: 15687405.

9. Korean Diabetes Association. Treatment guideline for diabetes. 5th ed. Seoul: Gold' Planning and Development;2015.

10. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics: 2014 update: a report from the American Heart Association. Circulation. 2014; 129:e28–e92. PMID: 24352519.

11. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek JW, Van Lente F. Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145:247–254. PMID: 16908915.

12. Ahn JH, Yu JH, Ko SH, Kwon HS, Kim DJ, Kim JH, Kim CS, Song KH, Won JC, Lim S, Choi SH, Han K, Cha BY, Kim NH. Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association. Prevalence and determinants of diabetic nephropathy in Korea: Korea National Health and Nutrition Examination Survey. Diabetes Metab J. 2014; 38:109–119. PMID: 24851205.

13. Jeon JY, Ko SH, Kwon HS, Kim NH, Kim JH, Kim CS, Song KH, Won JC, Lim S, Choi SH, Jang MJ, Kim Y, Oh K, Kim DJ, Cha BY. Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association. Prevalence of diabetes and prediabetes according to fasting plasma glucose and HbA1c. Diabetes Metab J. 2013; 37:349–357. PMID: 24199164.

14. Ko SH, Kwon HS, Kim DJ, Kim JH, Kim NH, Kim CS, Song KH, Won JC, Lim S, Choi SH, Han K, Park YM, Cha BY. Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association. Higher prevalence and awareness, but lower control rate of hypertension in patients with diabetes than general population: the fifth Korean National Health and Nutrition Examination Survey in 2011. Diabetes Metab J. 2014; 38:51–57. PMID: 24627828.

15. Roh E, Ko SH, Kwon HS, Kim NH, Kim JH, Kim CS, Song KH, Won JC, Kim DJ, Choi SH, Lim S, Cha BY. Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association. Prevalence and management of dyslipidemia in Korea: Korea National Health and Nutrition Examination Survey during 1998 to 2010. Diabetes Metab J. 2013; 37:433–449. PMID: 24404515.

16. Kim DJ. The epidemiology of diabetes in Korea. Diabetes Metab J. 2011; 35:303–308. PMID: 21977448.

17. Kim CS, Ko SH, Kwon HS, Kim NH, Kim JH, Lim S, Choi SH, Song KH, Won JC, Kim DJ, Cha BY. Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association. Prevalence, awareness, and management of obesity in Korea: data from the Korea National Health and Nutrition Examination Survey (1998-2011). Diabetes Metab J. 2014; 38:35–43. PMID: 24627826.

18. Warren B, Pankow JS, Matsushita K, Punjabi NM, Daya NR, Grams M, Woodward M, Selvin E. Comparative prognostic performance of definitions of prediabetes: a prospective cohort analysis of the Atherosclerosis Risk in Communities (ARIC) study. Lancet Diabetes Endocrinol. 2017; 5:34–42. PMID: 27863979.

19. Razavian N, Blecker S, Schmidt AM, Smith-McLallen A, Nigam S, Sontag D. Population-level prediction of type 2 diabetes from claims data and analysis of risk factors. Big Data. 2015; 3:277–287. PMID: 27441408.

20. Kim S, Moon S, Popkin BM. The nutrition transition in South Korea. Am J Clin Nutr. 2000; 71:44–53. PMID: 10617945.

21. Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003; 348:383–393. PMID: 12556541.

22. Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, Pasternak RC, Smith SC Jr, Stone NJ. National Heart, Lung, and Blood Institute. American College of Cardiology Foundation. American Heart Association. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004; 110:227–239. PMID: 15249516.

23. Ford ES. Trends in the control of risk factors for cardiovascular disease among adults with diagnosed diabetes: findings from the National Health and Nutrition Examination Survey 1999-2008*. J Diabetes. 2011; 3:337–347. PMID: 21767347.

24. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004; 351:1296–1305. PMID: 15385656.

25. Ko SH, Kim SR, Kim DJ, Oh SJ, Lee HJ, Shim KH, Woo MH, Kim JY, Kim NH, Kim JT, Kim CH, Kim HJ, Jeong IK, Hong EK, Cho JH, Mok JO, Yoon KH. Committee of Clinical Practice Guidelines, Korean Diabetes Association. 2011 Clinical practice guidelines for type 2 diabetes in Korea. Diabetes Metab J. 2011; 35:431–436. PMID: 22111032.

26. Noh J, Han KD, Ko SH, Ko KS, Park CY. Trends in the pervasiveness of type 2 diabetes, impaired fasting glucose and co-morbidities during an 8-year-follow-up of nationwide Korean population. Sci Rep. 2017; 7:46656. PMID: 28425463.

27. Kim JA, Yoon S, Kim LY, Kim DS. Towards actualizing the value potential of Korea Health Insurance Review and Assessment (HIRA) data as a resource for health research: strengths, limitations, applications, and strategies for optimal use of HIRA data. J Korean Med Sci. 2017; 32:718–728. PMID: 28378543.

28. Task Force Team for Basic Statistical Study of Korean Diabetes Mellitus of Korean Diabetes Association. Park IeB, 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; 37:233–239. PMID: 23991400.

29. Chun H, Kim IH, Min KD. Accuracy of self-reported hypertension, diabetes, and hypercholesterolemia: analysis of a representative sample of Korean older adults. Osong Public Health Res Perspect. 2016; 7:108–115. PMID: 27169009.

30. 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. PMID: 19675201.