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2021 Clinical Practice Guidelines for Diabetes Mellitus in Korea
Kyu Yeon Hur, Min Kyong Moon, Jong Suk Park, Soo-Kyung Kim, Seung-Hwan Lee, Jae-Seung Yun, Jong Ha Baek, Junghyun Noh, Byung-Wan Lee, Tae Jung Oh, Suk Chon, Ye Seul Yang, Jang Won Son, Jong Han Choi, Kee Ho Song, Nam Hoon Kim, Sang Yong Kim, Jin Wha Kim, Sang Youl Rhee, You-Bin Lee, Sang-Man Jin, Jae Hyeon Kim, Chong Hwa Kim, Dae Jung Kim, SungWan Chun, Eun-Jung Rhee, Hyun Min Kim, Hyun Jung Kim, Donghyun Jee, Jae Hyun Kim, Won Seok Choi, Eun-Young Lee, Kun-Ho Yoon, Seung-Hyun Ko, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2021;45(4):461-481.   Published online July 30, 2021
DOI: https://doi.org/10.4093/dmj.2021.0156
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  • 141 Web of Science
  • 157 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReader   ePub   
The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence that could be applicable in real-world practice and suitable for the Korean population. The guideline is provided for all healthcare providers including physicians, diabetes experts, and certified diabetes educators across the country who manage patients with diabetes or the individuals at the risk of developing diabetes mellitus. The recommendations for screening diabetes and glucose-lowering agents have been revised and updated. New sections for continuous glucose monitoring, insulin pump use, and non-alcoholic fatty liver disease in patients with diabetes mellitus have been added. The KDA recommends active vaccination for coronavirus disease 2019 in patients with diabetes during the pandemic. An abridgement that contains practical information for patient education and systematic management in the clinic was published separately.

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Original Article
Complications
Clinical Course and Risk Factors of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus in Korea
Jae-Seung Yun, Tae-Seok Lim, Seon-Ah Cha, Yu-Bae Ahn, Ki-Ho Song, Jin A Choi, Jinwoo Kwon, Donghyun Jee, Yang Kyung Cho, Yong-Moon Park, Seung-Hyun Ko
Diabetes Metab J. 2016;40(6):482-493.   Published online October 5, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.6.482
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

We investigated clinical course and risk factors for diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 759 patients with T2DM without DR were included from January 2001 to December 2004. Retinopathy evaluation was performed at least annually by ophthalmologists. The severity of the DR was classified into five categories according to the International Clinical Diabetic Retinopathy Severity Scales.

Results

Of the 759 patients, 523 patients (68.9%) completed the follow-up evaluation. During the follow-up period, 235 patients (44.9%) developed DR, and 32 patients (13.6%) progressed to severe nonproliferative DR (NPDR) or proliferative DR (PDR). The mean duration of diabetes at the first diagnosis of mild NPDR, moderate NPDR, and severe NPDR or PDR were 14.8, 16.7, and 17.3 years, respectively. After adjusting multiple confounding factors, the significant risk factors for the incidence of DR risk in patients with T2DM were old age, longer duration of diabetes, higher mean glycosylated hemoglobin (HbA1c), and albuminuria. Even in the patients who had been diagnosed with diabetes for longer than 10 years at baseline, a decrease in HbA1c led to a significant reduction in the risk of developing DR (hazard ratio, 0.73 per 1% HbA1c decrement; 95% confidence interval, 0.58 to 0.91; P=0.005).

Conclusion

This prospective cohort study demonstrates that glycemic control, diabetes duration, age, and albuminuria are important risk factors for the development of DR. More aggressive retinal screening for T2DM patients diagnosed with DR should be required in order to not miss rapid progression of DR.

Citations

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    Journal of Diabetes Research.2020; 2020: 1.     CrossRef
  • First nation-wide study of diabetic retinopathy in Poland in the years 2013–2017
    Milena Kozioł, Michał S. Nowak, Monika Udziela, Paweł Piątkiewicz, Iwona Grabska-Liberek, Jacek P. Szaflik
    Acta Diabetologica.2020; 57(10): 1255.     CrossRef
  • Awareness of diabetic retinopathy among Saudis with diabetes type 2 in Riyadh city
    YousefM Alluhaymid, FawzanY Alotaibi, AbdulmajeedB Alotaibi, AbdullahM Albasha, AbdulrahmanS Alnaim, EssaM Sabi, AhmedH Mujamammi
    Journal of Family Medicine and Primary Care.2020; 9(8): 4229.     CrossRef
  • Relationship between Clinical Features of Diabetic Retinopathy and Systemic Factors in Patients with Newly Diagnosed Type II Diabetes Mellitus
    Hyeseong Hwang, Jin Young Kim, Tae Keun Oh, Ju Byung Chae, Dong Yoon Kim
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
  • Longitudinal Screening for Diabetic Retinopathy in a Nationwide Screening Program: Comparing Deep Learning and Human Graders
    Jirawut Limwattanayingyong, Variya Nganthavee, Kasem Seresirikachorn, Tassapol Singalavanija, Ngamphol Soonthornworasiri, Varis Ruamviboonsuk, Chetan Rao, Rajiv Raman, Andrzej Grzybowski, Mike Schaekermann, Lily H. Peng, Dale R. Webster, Christopher Semtu
    Journal of Diabetes Research.2020; 2020: 1.     CrossRef
  • Association of Vitamin D and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus
    Rizwana Parveen, Pinki Mishra, Reema Singh, Prem Kapur, Nidhi B. Agarwal
    Annals of the National Academy of Medical Sciences (India).2020; 53: 156.     CrossRef
  • Protective factors for diabetic retinopathy in Type 2 diabetes mellitus patients: Long duration of no less than 10 years
    Yanli Liu, Chunwen Duan, Dejia Fang, Yi Liu, Hanchun Xu, Yarong Zheng, Yaling Xuan, Lili Wang, Lin Ye, Rui Su, Meixia An
    Journal of Diabetes and its Complications.2019; 33(10): 107383.     CrossRef
  • Incidence of sight‐threatening diabetic retinopathy in people with Type 2 diabetes mellitus and numbers needed to screen: a systematic review
    Y. Groeneveld, D. Tavenier, J.W. Blom, B.C.P. Polak
    Diabetic Medicine.2019; 36(10): 1199.     CrossRef
  • Association between spousal diabetes status and diabetic retinopathy in Chinese patients with type 2 diabetes
    Mei Yang, Yu Liu, Cuihong Wen, Beirui Wu, Xu Wan, Wei Luan, Jie Shen, Wei Liu, Jing Ma
    Diabetes and Vascular Disease Research.2019; 16(5): 474.     CrossRef
  • Presence of diabetic retinopathy is lower in type 2 diabetic patients with non-alcoholic fatty liver disease
    Meng Zhang, Li Li, Jing Chen, Bei Li, Yutao Zhan, Chuan Zhang
    Medicine.2019; 98(18): e15362.     CrossRef
  • MicroRNAs as biomarkers of diabetic retinopathy and disease progression
    Bridget Martinez, PhilipV Peplow
    Neural Regeneration Research.2019; 14(11): 1858.     CrossRef
  • Vascular changes in diabetic retinopathy—a longitudinal study in the Nile rat
    Huishi Toh, Alexander Smolentsev, Rachel V. Bozadjian, Patrick W. Keeley, Madison D. Lockwood, Ryan Sadjadi, Dennis O. Clegg, Barbara A. Blodi, Peter J. Coffey, Benjamin E. Reese, James A. Thomson
    Laboratory Investigation.2019; 99(10): 1547.     CrossRef
  • DIABETE, TABAGISMO E DISASSUEFAZIONE DAL FUMO
    Davide Campagna, Angela Alamo, Enrico Mondati, Riccardo Polosa
    il Diabete.2019; 31(N. 1, marz): 41.     CrossRef
  • Smoking and diabetes: dangerous liaisons and confusing relationships
    D. Campagna, A. Alamo, A. Di Pino, C. Russo, A. E. Calogero, F. Purrello, R. Polosa
    Diabetology & Metabolic Syndrome.2019;[Epub]     CrossRef
  • Letter: Dipeptidyl Peptidase-4 Inhibitors versus Other Antidiabetic Drugs Added to Metformin Monotherapy in Diabetic Retinopathy Progression: A Real World-Based Cohort Study (Diabetes Metab J 2019;43:640–8)
    Jun Sung Moon
    Diabetes & Metabolism Journal.2019; 43(6): 911.     CrossRef
  • Past and Current Status of Adult Type 2 Diabetes Mellitus Management in Korea: A National Health Insurance Service Database Analysis
    Seung-Hyun Ko, Kyungdo Han, Yong-ho Lee, Junghyun Noh, Cheol-Young Park, Dae-Jung Kim, Chang Hee Jung, Ki-Up Lee, Kyung-Soo Ko
    Diabetes & Metabolism Journal.2018; 42(2): 93.     CrossRef
  • Excess visceral adiposity is associated with diabetic retinopathy in a multiethnic Asian cohort with longstanding type 2 diabetes
    Angela Moh, Kumari Neelam, Xiao Zhang, Chee Fang Sum, Subramaniam Tavintharan, Keven Ang, Simon Biing Ming Lee, Wern Ee Tang, Su Chi Lim
    Endocrine Research.2018; 43(3): 186.     CrossRef
  • RNA sequencing identified specific circulating miRNA biomarkers for early detection of diabetes retinopathy
    Zhen Liang, Kai P. Gao, Yi X. Wang, Zi C. Liu, Li Tian, Xin Z. Yang, Jing Y. Ding, Wei T. Wu, Wen H. Yang, Yi L. Li, Ze B. Zhang, Ri H. Zhai
    American Journal of Physiology-Endocrinology and Metabolism.2018; 315(3): E374.     CrossRef
  • High hemoglobin levels are associated with decreased risk of diabetic retinopathy in Korean type 2 diabetes
    Min-Kyung Lee, Kyung-Do Han, Jae-Hyuk Lee, Seo-Young Sohn, Jee-Sun Jeong, Mee-Kyoung Kim, Ki-Hyun Baek, Ki-Ho Song, Hyuk-Sang Kwon
    Scientific Reports.2018;[Epub]     CrossRef
  • Cigarette Smoking, Diabetes, and Diabetes Complications: Call for Urgent Action
    Ping Zhu, Xiong-Fei Pan, Liting Sheng, Henggui Chen, An Pan
    Current Diabetes Reports.2017;[Epub]     CrossRef
  • Response: Features of Long-Standing Korean Type 2 Diabetes Mellitus Patients with Diabetic Retinopathy: A Study Based on Standardized Clinical Data (Diabetes Metab J 2017;41:393-404)
    Sang Youl Rhee, Jeong-Taek Woo
    Diabetes & Metabolism Journal.2017; 41(6): 494.     CrossRef
  • Letter: Clinical Course and Risk Factors of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus in Korea (Diabetes Metab J2016;40:482-93)
    Nam Hoon Kim
    Diabetes & Metabolism Journal.2017; 41(1): 75.     CrossRef
  • Combined treatment of diabetic nephropathy with alprostadil and calcium dobesilate
    Lili Qin, Wenjun Qin, Jianfei Wang, Lin Lin
    Experimental and Therapeutic Medicine.2017;[Epub]     CrossRef
  • Response: Clinical Course and Risk Factors of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus in Korea (Diabetes Metab J2016;40:482-93)
    Jae-Seung Yun, Seung-Hyun Ko
    Diabetes & Metabolism Journal.2017; 41(1): 77.     CrossRef
  • Clinical characteristics and risk factors for retinal diabetic neurodegeneration in type 2 diabetes
    Kiyoung Kim, Eung Suk Kim, Sang Youl Rhee, Suk Chon, Jeong-taek Woo, Seung-Young Yu
    Acta Diabetologica.2017; 54(11): 993.     CrossRef
  • Letter: Features of Long-Standing Korean Type 2 Diabetes Mellitus Patients with Diabetic Retinopathy: A Study Based on Standardized Clinical Data (Diabetes Metab J 2017;41:393-404)
    Jae-Seung Yun
    Diabetes & Metabolism Journal.2017; 41(6): 492.     CrossRef

Diabetes Metab J : Diabetes & Metabolism Journal
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