Diabetes & Metabolism Journal

Original Articles

Metabolic Risk/Epidemiology
Beta-Cell Function, Insulin Sensitivity, and Metabolic Characteristics in Young-Onset Type 2 Diabetes Mellitus: Findings from Anam Diabetes Observational Study: Ji Yoon Kim, Jiyoon Lee, Sin Gon Kim, Nam Hoon Kim; Diabetes Metab J. 2025;49(6):1287-1297. Published online May 21, 2025; DOI: https://doi.org/10.4093/dmj.2024.0601

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Background
In this study, we aimed to determine the metabolic characteristics and changes in the early stages of young-onset type 2 diabetes mellitus (YOD) in Koreans.
Methods
From the Anam Diabetes Observational Study cohort (2017–2023), the characteristics of newly diagnosed YOD (<40 years of age, n=39) and later-onset (≥40 years of age) type 2 diabetes mellitus (LOD, n=178) were compared at diagnosis and 1 year later. All participants underwent an oral glucose tolerance test at diagnosis and annually thereafter. β-Cell function was determined using the disposition index (DI), calculated as the insulinogenic index×Matsuda insulin sensitivity index (ISI). Insulin sensitivity was determined using ISI and homeostasis model assessment of insulin resistance (HOMA2-IR).
Results
Mean (±standard deviation) age of individuals with YOD was 29.8±6.4 years, and 76.9% were male. YOD patients had higher body mass index (29.8 kg/m² vs. 27.2 kg/m², P=0.020), fat mass (30.5 kg vs. 24.1 kg, P=0.011), fatty liver index (65.4 vs. 49.2, P=0.005), and glycosylated hemoglobin (HbA1c) level at diagnosis (9.3% vs. 7.7%, P<0.001) compared with LOD patients. YOD patients exhibited lower insulin sensitivity (ISI: 2.79 vs. 3.26, P=0.008; HOMA2-IR: 2.72 vs. 1.83, P<0.001) and β-cell function (DI) at diagnosis (0.41 vs. 0.72, P=0.003) than LOD patients. Following 1 year of treatment, DI improved by 94% in YOD along with improvement in HbA1c; however, it was still significantly lower than that of LOD (0.64 vs. 0.90, P=0.017).
Conclusion
Individuals with YOD have unfavorable metabolic characteristics, substantially reduced insulin sensitivity, and decompensated β-cell function at disease onset, which persist even after treatment.

Citations

Citations to this article as recorded by

Compensated But Failing: Early β‐Cell Dysfunction Under Normoglycemia in Children and Adolescents With Overweight and Obesity
Paulina Correa‐Burrows, Estela Blanco, Raquel Burrows
Diabetes/Metabolism Research and Reviews.2026;[Epub] CrossRef
Remission in Young-Onset Type 2 Diabetes: Mechanisms, Intervention Strategies, and Predictive Factors
易宏邹
Advances in Clinical Medicine.2026; 16(05): 301. CrossRef
Targeting Mitochondria in Aging‐Related Diseases: Therapeutic Potential and Obstacles
Zijie Xiang, Yu Chen, Xishui Liu, Haowen Lu, Yuqing Yang, Lei Xing, Yu Zhang, Chuandong Lang, Siming Zhang, Shixiang Zhao, Youzhi Hong, Jiaxiang Bai, Yusen Qiao
MedComm.2026;[Epub] CrossRef
Circulating GDF15 levels reflect metabolic and inflammatory burden in early dysglycemia: findings from the ADIOS cohort
Ji Yoon Kim, Ah Hyeon Lee, Jiyoon Lee, Hye-Min Jang, Sin Gon Kim, Dong-Hoon Kim, Nam Hoon Kim
Diabetes Research and Clinical Practice.2026; 239: 113461. CrossRef

Guideline/Statement/Fact Sheet
Prevalence, Incidence, and Metabolic Characteristics of Young Adults with Type 2 Diabetes Mellitus in South Korea (2010–2020): Ji Yoon Kim, Jiyoon Lee, Joon Ho Moon, Se Eun Park, Seung-Hyun Ko, Sung Hee Choi, Nam Hoon Kim; Diabetes Metab J. 2025;49(2):172-182. Published online March 1, 2025; DOI: https://doi.org/10.4093/dmj.2024.0826

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501 Download
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Background
This study aimed to examine trends in the prevalence, incidence, metabolic characteristics, and management of type 2 diabetes mellitus (T2DM) among young adults in South Korea.
Methods
Young adults with T2DM were defined as individuals aged 19 to 39 years who met the diagnostic criteria for T2DM. Data from the Korean National Health Insurance Service-Customized Database (2010–2020, n=225,497–372,726) were analyzed to evaluate trends in T2DM prevalence, incidence, metabolic profiles, comorbidities, and antidiabetic drug prescription. Additional analyses were performed using the Korea National Health and Nutrition Examination Survey.
Results
The prevalence of T2DM in young adults significantly increased from 1.02% in 2010 to 2.02% in 2020 (P<0.001), corresponding to 372,726 patients in 2020. Over the same period, the incidence rate remained stable within the range of 0.36% to 0.45%. Prediabetes prevalence steadily increased from 15.53% to 20.92%, affecting 3.87 million individuals in 2020. The proportion of young adults with T2DM who were obese also increased, with 67.8% having a body mass index (BMI) ≥25 kg/m² and 31.6% having a BMI ≥30 kg/m² in 2020. The prevalence of hypertension, dyslipidemia, and fatty liver disease also increased, reaching 34.2%, 79.8%, and 78.9%, respectively, in 2020. Although the overall pharmacological treatment rate remained low, the prescription of antidiabetic medications with weight-reducing properties increased over the study period.
Conclusion
The prevalence of T2DM among young adults in South Korea nearly doubled over the past decade. The strong association with obesity and metabolic comorbidities emphasizes the urgent need for targeted prevention and management strategies tailored to this population.

Citations

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Association between body weight time in target range and risk of type 2 diabetes in adults with obesity
Soojin Park, Seohyun Kim, Sang Ho Park, Minkyeong Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim, Gyuri Kim
Diabetology & Metabolic Syndrome.2026;[Epub] CrossRef
Diabetes Fact Sheet 2025: Comparative Epidemiology and Clinical Features of Obese and Non-Obese Diabetes in Korea
Jin Hwa Kim, Bongseong Kim, Se Eun Park, Seung-Hyun Ko, Sung Hee Choi, Bong Soo Cha, Kyungdo Han, Seung-Hwan Lee
Diabetes & Metabolism Journal.2026; 50(2): 267. CrossRef
Diabetes Fact Sheet 2025: Special Edition on Diabetes with Obesity and in Pregnancy
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Diabetes & Metabolism Journal.2026; 50(2): 255. CrossRef
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Hwa Young Kim, Eunjeong Ji, Jaehyun Kim
Diabetes Research and Clinical Practice.2026; 236: 113285. CrossRef
Association between relative handgrip strength and glycemic control among male automobile manufacturing workers using vibration tools in South Korea
Dong-Jae Seo, Hyun Joong Kim, Yongjin Kim, Jaewon Mun, Jong-Han Leem, Shin-Goo Park, Dong-Wook Lee, Hwan-Cheol Kim
Annals of Occupational and Environmental Medicine.2026; 38: e14. CrossRef
Hypertriglyceridemia in adults with diabetes mellitus in Korea: Sex, age, and lifestyle determinants
Kye-Yeung Park, Sangmo Hong, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
Journal of Clinical Lipidology.2026; 20(7): 1377. CrossRef
Remission in Young-Onset Type 2 Diabetes: Mechanisms, Intervention Strategies, and Predictive Factors
易宏邹
Advances in Clinical Medicine.2026; 16(05): 301. CrossRef
Sex-stratified associations of TyG index and HOMA-IR changes with incident type 2 diabetes
Sojin Kim, Sujeong Shin, Yoosoo Chang, Eunju Sung, Jae-Heon Kang
Scientific Reports.2026;[Epub] CrossRef
Circulating GDF15 levels reflect metabolic and inflammatory burden in early dysglycemia: findings from the ADIOS cohort
Ji Yoon Kim, Ah Hyeon Lee, Jiyoon Lee, Hye-Min Jang, Sin Gon Kim, Dong-Hoon Kim, Nam Hoon Kim
Diabetes Research and Clinical Practice.2026; 239: 113461. CrossRef
Vegetable‐First Meal Sequence Suppresses Postprandial Glycaemic Excursions and Variability in Young Women With High‐Risk Phenotype for Early‐Onset Type 2 Diabetes: A 4‐Arm Randomized Crossover Trial With Continuous Glucose Monitoring
Minji Choi, Soyoon Lee, Eujean Bang, Ijae Seo, Jieun Lee, Sehyun Joo, Hyeonseo Kim, Song Vogue Ahn, Yuri Kim, Jieun Oh
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Machine learning models for predicting new-onset diabetes following acute pancreatitis using real-world data
Djibril M Ba, Alireza Vafaei Sadr, Yue Zhang, Phil A. Hart, Nazia Raja-Khan, Ruizhe Zhou, Ayesha Siddiqui, Tian Qiu, Jennifer Maranki, Vernon M. Chinchilli, Vida Abedi
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Physical activity and type 2 diabetes risk
Jing Liu, Qingtao Zeng
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Association of temporal MASLD with type 2 diabetes, cardiovascular disease and mortality
Eugene Han, Kyung-Do Han, Yong-ho Lee, Kyung-Soo Kim, Sangmo Hong, Jung Hwan Park, Cheol-Young Park
Cardiovascular Diabetology.2025;[Epub] CrossRef
Fenofibrate therapy and risk of heart failure outcomes in patients with Type 2 diabetes: a propensity-matched cohort study
Ji Yoon Kim, Nam Hoon Kim, Jiyoon Lee, Dong-Hoon Kim, Sin Gon Kim
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Gergő A. Molnár, Zoltán Kiss, István Wittmann
Frontiers in Endocrinology.2025;[Epub] CrossRef
Cost-Effectiveness Analysis of Real-Time Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in People With Type 2 Diabetes Treated With Non-Intensive Insulin Therapy in South Korea
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Can screening for albuminuria detect type 2 diabetes mellitus?
Mi Kyung Kim
Kidney Research and Clinical Practice.2025; 44(6): 857. CrossRef
Association between severe acute pancreatitis and new-onset diabetes: a propensity score-matched real-world study
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Frontiers in Endocrinology.2025;[Epub] CrossRef

Pathophysiology
Recent Glycemia Is a Major Determinant of β-Cell Function in Type 2 Diabetes Mellitus: Ji Yoon Kim, Jiyoon Lee, Sin Gon Kim, Nam Hoon Kim; Diabetes Metab J. 2024;48(6):1135-1146. Published online June 17, 2024; DOI: https://doi.org/10.4093/dmj.2023.0359

11,691 View
223 Download
10 Web of Science
12 Crossref

Abstract PDF Supplementary Material PubReader ePub

Background
Progressive deterioration of β-cell function is a characteristic of type 2 diabetes mellitus (T2DM). We aimed to investigate the relative contributions of clinical factors to β-cell function in T2DM.
Methods
In a T2DM cohort of 470 adults (disease duration 0 to 41 years), β-cell function was estimated using insulinogenic index (IGI), disposition index (DI), oral disposition index (DIO), and homeostasis model assessment of β-cell function (HOMA-B) derived from a 75 g oral glucose tolerance test (OGTT). The relative contributions of age, sex, disease duration, body mass index, glycosylated hemoglobin (HbA1c) levels (at the time of the OGTT), area under the curve of HbA1c over time (HbA1c AUC), coefficient of variation in HbA1c (HbA1c CV), and antidiabetic agents use were compared by standardized regression coefficients. Longitudinal analyses of these indices were also performed.
Results
IGI, DI, DI_O, and HOMA-B declined over time (P<0.001 for all). Notably, HbA1c was the most significant factor affecting IGI, DI, DIO, and HOMA-B in the multivariable regression analysis. Compared with HbA1c ≥9%, DI was 1.9-, 2.5-, 3.7-, and 5.5-fold higher in HbA1c of 8%–<9%, 7%–<8%, 6%–<7%, and <6%, respectively, after adjusting for confounding factors (P<0.001). Conversely, β-cell function was not affected by the type or duration of antidiabetic agents, HbA1c AUC, or HbA1c CV. The trajectories of the IGI, DI, DIO, and HOMA-B mirrored those of HbA1c.
Conclusion
β-Cell function declines over time; however, it is flexible, being largely affected by recent glycemia in T2DM.

Citations

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An interpretable machine learning model for predicting metabolic dysfunction‐associated steatotic liver disease in patients with type 2 diabetes
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Machine learning and engagement insights for personalized blood glucose management
Inbar Breuer Asher, David L. Horwitz, Omar Manejwala, Yifat Fundoiano-Hershcovitz
Frontiers in Digital Health.2026;[Epub] CrossRef
Redefining β-Cell Function in Type 2 Diabetes Mellitus: From Comprehensive Assessment to Precision Medicine
YongKyung Kim, Joon Ha, Jun Sung Moon
Diabetes & Metabolism Journal.2026; 50(2): 235. CrossRef
Compensated But Failing: Early β‐Cell Dysfunction Under Normoglycemia in Children and Adolescents With Overweight and Obesity
Paulina Correa‐Burrows, Estela Blanco, Raquel Burrows
Diabetes/Metabolism Research and Reviews.2026;[Epub] CrossRef
The influence of emotions and healthcare provider interactions on self-management behavior and HbA1c in Korean patients with type 2 diabetes mellitus: a cross-sectional descriptive study
Sunjoo Lee, Jieun Cha
Journal of Korean Biological Nursing Science.2026; 28(2): 330. CrossRef
Methodological considerations in the assessment of time in range during caloric restriction in type 2 diabetes with obesity
Ying Li
Journal of Diabetes Investigation.2026;[Epub] CrossRef
Circulating GDF15 levels reflect metabolic and inflammatory burden in early dysglycemia: findings from the ADIOS cohort
Ji Yoon Kim, Ah Hyeon Lee, Jiyoon Lee, Hye-Min Jang, Sin Gon Kim, Dong-Hoon Kim, Nam Hoon Kim
Diabetes Research and Clinical Practice.2026; 239: 113461. CrossRef
Associations of the unhealthy plant-based diet index with hsCRP and BMI in Korean adults
Ara Yoo, Injoong Shin, Hyoyeon Son, Won Jang, Hyesook Kim
Frontiers in Nutrition.2026;[Epub] CrossRef
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Minyoung Lee, Sukchul Hong, Yongin Cho, Hyungjin Rhee, Min Heui Yu, Jaehyun Bae, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha
BMC Medicine.2025;[Epub] CrossRef
Beta-Cell Function, Insulin Sensitivity, and Metabolic Characteristics in Young-Onset Type 2 Diabetes Mellitus: Findings from Anam Diabetes Observational Study
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Unlocking Gut-Driven Metabolic Repair: The Role of Glucomannan Porang (Amorphophallus muelleri Blume) in Insulin Resistance and Short-Chain Fatty Acid Modulation in a Type 2 Diabetes Mellitus Rat Model
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Diabetes & Metabolism Journal.2024; 48(6): 1056. CrossRef

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