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Original Articles
Lifestyle and Behavioral Interventions
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Association between Changes in Physical Activity and Incident Depression among Patients with Newly Diagnosed Type 2 Diabetes Mellitus
Sangwoo Park, Back Kim, Hye Jun Kim, Sun Jae Park, Jihun Song, Jina Chung, Seogsong Jeong, Sang Min Park, Dae Ho Lee, Soo Jung Choi
Received August 17, 2025  Accepted December 18, 2025  Published online February 23, 2026  
DOI: https://doi.org/10.4093/dmj.2025.0766    [Epub ahead of print]
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aims to investigate the relationship between changes in physical activity patterns following a new diagnosis of type 2 diabetes mellitus (T2DM) and the risk of developing depression.
Methods
This study utilized comprehensive diabetes data from the National Health Insurance Service of South Korea. From this dataset, we included 254,619 individuals newly diagnosed with T2DM between 2009 and 2015 who had health examination data within 2 years before and after their diagnosis date and no prior history of depression. Physical activity levels were quantified using the metabolic equivalent of task (MET) method.
Results
Compared to individuals with 0 MET-min/wk of physical activity prior to a new T2DM diagnosis, those who increased their activity levels to 500–999 MET-min/wk after diagnosis showed a 23% reduction in the risk of depression, while an increase to ≥1,000 MET-min/wk was associated with a 25% reduction in depression risk. Conversely, individuals with 1–499 MET-min/wk before diagnosis who became inactive after diagnosis experienced a 25% increased risk of depression. A similar trend of increased depression risk was observed in those who reduced their physical activity from 500–999 or ≥1,000 MET-min/wk.
Conclusion
Changes in physical activity levels before and after a new diagnosis of T2DM significantly influence the risk of developing depression, with increased activity reducing the risk and decreased activity elevating the risk. This finding underscores the importance of encouraging physical activity to support mental health in patients with newly diagnosed T2DM.
Genetics
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SLC30A8 Rare Variant Modify Contribution of Common Genetic and Lifestyle Factors toward Type 2 Diabetes Mellitus
Hye-Mi Jang, Mi Yeong Hwang, Yi Seul Park, Bong-Jo Kim, Young Jin Kim
Diabetes Metab J. 2026;50(2):385-395.   Published online August 13, 2025
DOI: https://doi.org/10.4093/dmj.2024.0830
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to investigate the modifying effects of rare genetic variants on the risk of type 2 diabetes mellitus (T2DM) in the context of common genetic and lifestyle factors.
Methods
We conducted a comprehensive analysis of genetic and lifestyle factors associated with T2DM in a cohort of 146,284 Korean individuals. Among them, 4,603 individuals developed T2DM during the follow-up period of up to 17 years. We calculated a polygenic risk score (PRS) for T2DM and identified carriers of the rare allele I349F at SLC30A8. A Healthy Lifestyle Score (HLS) was also derived from physical activity, obesity, smoking, diet, and sodium intake levels. Using Cox proportional hazards models, we analyzed how PRS, HLS, and I349F influenced T2DM incidence.
Results
Results showed that high PRS and poor lifestyle were associated with increased risk. Remarkably, I349F carriers exhibited a lower T2DM prevalence (5.7% compared to 11.7% in non-carriers) and reduced the impact of high PRS from 23.18% to 12.70%. This trend was consistent across different HLS categories, with I349F carriers displaying a lower risk of T2DM.
Conclusion
The integration of common and rare genetic variants with lifestyle factors enhanced T2DM predictability in the Korean population. Our findings highlight the critical role of rare genetic variants in risk assessments and suggest that standard PRS and HLS metrics alone may be inadequate for predicting T2DM risk among carriers of such variants.

Citations

Citations to this article as recorded by  
  • Personalised Nutrition in Obesity and Prediabetes: Do Genotypes Matter?
    Magdalena Bossowska, Filip Bossowski, Edyta Adamska-Patruno, Katarzyna Maliszewska, Adam Krętowski
    Nutrients.2026; 18(5): 815.     CrossRef
  • Differential contributions of cardiovascular health-related lifestyle factors to epigenetic ageing: implications for healthy longevity
    Da-eun Lee, Yi Seul Park, Hye-Mi Jang, Bong-Jo Kim, Young Jin Kim, Sung-il Cho, Kyeezu Kim
    BMC Medicine.2025;[Epub]     CrossRef
Review
Others
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Differences between Type 2 Diabetes Mellitus and Obesity Management: Medical, Social, and Public Health Perspectives
Soo Lim, Ga Eun Nam, Arya M. Sharma
Diabetes Metab J. 2025;49(4):565-579.   Published online June 11, 2025
DOI: https://doi.org/10.4093/dmj.2025.0278
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  • 3 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Obesity and type 2 diabetes mellitus (T2DM) are among the most urgent global public health challenges, yet differ markedly in recognition and management across medical, social, infrastructure, and policy domains. T2DM is supported by clear diagnostic criteria, defined treatment targets, and broad acceptance as a chronic disease. In contrast, obesity is assessed using imprecise metrics like body mass index, lacks standardized treatment goals, and is often misunderstood as a lifestyle issue rather than a chronic, relapsing disease. This misconception contributes to stigma, discrimination, and unrealistic patient expectations. T2DM receives substantial research funding, comprehensive clinical guidelines, and structured medical education, with strong support from large professional societies and multidisciplinary care models. Obesity care remains underfunded, inconsistently delivered, and underrepresented in medical training. Public health and policy efforts strongly favor T2DM, providing coordinated programs, insurance coverage, and regulatory oversight. Conversely, obesity is marginalized, with limited policy influence and a largely unregulated commercial weight-loss industry. Bridging these disparities requires adopting lessons from T2DM management—such as evidence-based guidelines, improved provider training, expanded insurance coverage, and public health strategies—to enhance obesity care and recognize it as a chronic disease requiring long-term, structured management.

Citations

Citations to this article as recorded by  
  • Diabetes Fact Sheet 2025: Special Edition on Diabetes with Obesity and in Pregnancy
    Se Eun Park, Se Hee Min, Jin Hwa Kim, Seung-Hwan Lee, Han Na Jung, Joon Ho Moon, Kyungdo Han, Seung-Hyun Ko, Bong Soo Cha, Sung Hee Choi
    Diabetes & Metabolism Journal.2026; 50(2): 255.     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
  • GLP-1 Receptor Agonists: Advances in Mechanism, Therapeutic Applications, and Future Perspectives
    Megha Pawar, Chandrashekhar Patil, Zubershaha Fakir, Durgesh Pagar, Sunil Mahajan
    BioMed Target Journal.2025; 3(2): 18.     CrossRef
Original Articles
Metabolic Risk/Epidemiology
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Birth Weight, Cardiovascular Health, and Microvascular Complications in Individuals with Diabetes Mellitus
Chaolun Yu, Anping Feng, Xia Zou, Siqi Chen, Lingyan Dai, Qingmei Cui, Xiaojing Kuang, Gaoli She, Ying Ma, Haixia Guan, Jie Li
Diabetes Metab J. 2025;49(5):1075-1086.   Published online May 23, 2025
DOI: https://doi.org/10.4093/dmj.2024.0518
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Diabetes often leads to microvascular complications, including nephropathy, neuropathy, and retinopathy. Understanding the impact of early-life factors like birth weight and modifiable behaviors such as cardiovascular health (CVH) is essential for preventing these complications.
Methods
We included 11,515 participants with diabetes but without microvascular complications at baseline from the UK Biobank Study. CVH was evaluated using the Life’s Essential 8 score. Independent and joint associations of birth weight and CVH with microvascular complications were analyzed using Cox proportional hazard models. Two-sample Mendelian randomization (MR) analyses estimated unconfounded associations between birth weight and microvascular complications.
Results
Over a median follow-up of 13.1 years, 3,010 microvascular complications occurred. Compared with normal birth weight (2.5–4.0 kg), low birth weight (LBW; <2.5 kg) was associated with 15% higher risk of diabetic nephropathy (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.01 to 1.31), but not with neuropathy and retinopathy. High birth weight (>4.0 kg) was not associated with the risk of diabetic microvascular complications. MR analysis confirmed the association between LBW and nephropathy. Adherence to high CVH was associated with a reduced risk of microvascular complications compared to low CVH, regardless of birth weight. The HRs were 0.70 (95% CI, 0.59 to 0.84) for the LBW group and 0.74 (95% CI, 0.68 to 0.80) for the group with birth weight ≥2.5 kg (P for interaction=0.69).
Conclusion
LBW was an independent risk factor for nephropathy among diabetic patients. However, the detrimental effects of LBW might be mitigated by improvement in CVH.
Technology/Device
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Current Status of Continuous Glucose Monitoring Use in South Korean Type 1 Diabetes Mellitus Population–Pronounced Age-Related Disparities: Nationwide Cohort Study
Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetes Metab J. 2025;49(5):1040-1050.   Published online April 28, 2025
DOI: https://doi.org/10.4093/dmj.2024.0804
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  • 7 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aims to identify the status of continuous glucose monitoring (CGM) use among individuals with type 1 diabetes mellitus (T1DM) in South Korea and to investigate whether age-related disparities exist.
Methods
Individuals with T1DM receiving intensive insulin therapy were identified from the Korean National Health Insurance Cohort (2019–2022). Characteristics of CGM users and non-users were compared, and the prescription rates of CGM and sensor- augmented pump (SAP) or automated insulin delivery (AID) systems according to age groups (<19, 19–39, 40–59, and ≥60 years) were analyzed using chi-square tests. Glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CV) among CGM users were also examined.
Results
Among the 56,908 individuals with T1DM, 10,822 (19.0%) used CGM at least once, and 6,073 (10.7%) used CGM continuously. Only 241 (0.4%) individuals utilized either SAP or AID systems. CGM users were younger than non-users. The continuous prescription rate of CGM was highest among individuals aged <19 years (37.0%), followed by those aged 19–39 years (15.8%), 40–59 years (10.7%), and ≥60 years (3.9%) (P<0.001 for between-group differences). Among CGM users, HbA1c levels decreased from 8.7%±2.4% at baseline to 7.2%±1.2% at 24 months, and CV decreased from 36.6%±11.9% at 3 months to 34.1%±12.7% at 24 months.
Conclusion
Despite national reimbursement for CGM devices, the prescription rates of CGM remain low, particularly among older adults. Given the improvements in HbA1c and CV following CGM initiation, more efforts are needed to increase CGM utilization and reduce age-related disparities.

Citations

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  • Association of perceived diabetes stigma with time below range <3.0 mmol/L and anxiety in adults with type 1 diabetes using continuous glucose monitoring
    Seohyun Kim, Soojin Park, Sang‐Man Jin, Jae Hyeon Kim, Gyuri Kim
    Diabetic Medicine.2026;[Epub]     CrossRef
  • Suboptimal adoption of diabetes technology despite coverage and the impact on glycemic outcomes in children and adolescents with type 1 diabetes in Hong Kong
    Sarah Wing-yiu Poon, Kwong-tat Chan, Betty Wai-man But, Shirley Man-yee Wong, Wing-in Yam, Pik-to Cheung, Wing-shan See, Suk-yan Chan, Ho-chung Yau, Eunice Wai Yu Wong, Lap Ming Wong, Antony Chun-cheung Fu, Elaine Yin-wah Kwan, Janez Heung-ching Tsui, Sin
    Journal of Pediatric Endocrinology and Metabolism.2026; 39(3): 251.     CrossRef
  • Preliminary clinical outcomes and adoption of continuous glucose monitoring following reimbursement implementation in patients with type 1 diabetes in Thailand
    Nichapa Yordsudueam, Nattakarn Numsriskulrat, Worapimon Lerdrassameethad, Pattayarporn Paleekul, Jutipond jitchana, Nitchakarn Laichuthai, Taninee Sahakitrungruang
    Annals of Pediatric Endocrinology & Metabolism.2026; 31(1): 66.     CrossRef
  • Challenges and Opportunities for Improving Care for Type 1 Diabetes in Older Adulthood
    Anna R. Kahkoska, Joshua J. Neumiller, Anastasia-Stefania Alexopoulos, Amlan Barik, Elbert S. Huang, Lori M. Laffel, Naushira Pandya, Christine Slyne, Elena Toschi, Ruth S. Weinstock, Medha Munshi
    Diabetes Care.2026; 49(4): 559.     CrossRef
  • Continuous glucose monitoring and risks of acute and chronic diabetes-related complications and mortality in adults with type 1 diabetes: a nationwide cohort study
    Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
    Diabetologia.2026;[Epub]     CrossRef
  • Sequential use of continuous glucose monitoring, with or without exercise trackers, significantly improves glycemic control in patients with type 2 diabetes
    Anushka Lahiri, Suan Tee Lim, Htike Kyu, Yock Young Dan, Chin Meng Khoo
    Diabetology & Metabolic Syndrome.2025;[Epub]     CrossRef
  • Efficacy and Safety of Stage 5 Connected Insulin Pens in Type 1 or Type 2 Diabetes: Randomized Controlled Trial Protocol
    Ji Yoon Kim, Nam Hoon Kim, Soo Heon Kwak, Chang Hee Jung, Eun Seok Kang, Jun Sung Moon, Sun Joon Moon, So Yoon Kwon, Jee Hee Yoo, Younghoon Kim, Tae-min Lee, Chung-il Yang, Jae Hyeon Kim, Sang-Man Jin
    Endocrinology and Metabolism.2025;[Epub]     CrossRef
Lifestyle and Behavioral Interventions
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Association between Healthy Lifestyle Factors and Metabolic Syndrome Risk: A Prospective Analysis of the Korean Genome and Epidemiology Study
Jialei Fu, Sangah Shin
Diabetes Metab J. 2025;49(4):873-882.   Published online March 26, 2025
DOI: https://doi.org/10.4093/dmj.2024.0427
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To investigate the association of adherence to five modifiable lifestyle factors (limiting alcohol, physical activity, limiting smoking, favorable diet quality, and adequate sleep) with metabolic syndrome (MetS) risk in Korean adults.
Methods
Health Examinees Study data were used, and 41,368 participants aged 40 to 69 years were included. Cox proportional hazards regression analyses assessed the associations of individual and combined healthy lifestyle factors (32 and 16 lifestyle profiles in men and women.
Results
During a median 4.2-year follow-up, 6,213 participants were newly diagnosed with MetS. Adherence to more healthy lifestyle factors (4–5 vs. 0–1) could lower MetS risk by 28% and 12% in men and women (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.63 to 0.83 in men; HR, 0.88; 95% CI, 0.78 to 0.99 in women). Each additional healthy lifestyle could reduce the risk of MetS by 10% and 6% in men and women. The pooled analysis yielded similar results based on similar numbers of healthy lifestyle factors, the risk of MetS decreased as the number of healthy lifestyle factors increased.
Conclusion
Adherence to more healthy lifestyle factors was inversely associated with MetS risk. These findings highlight the importance of limiting drinking in managing MetS. Future research should consider the synergistic effects of emerging lifestyle factors, such as sleep duration, on chronic disease development, while focusing on the effects of traditional lifestyle factors.

Citations

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  • Adherence to Healthy Lifestyle and Risk of Cardiometabolic Diseases in Individuals With Hypertension
    Zixin Qiu, Gang Liu, Yang Hu, Siyue Wang, Binkai Liu, Eric B. Rimm, Molin Wang, JoAnn E. Manson, Frank B. Hu, Qi Sun
    JAMA Network Open.2026; 9(3): e260937.     CrossRef
  • Inverse associations between the dietary diabetes risk reduction score and dietary phytochemical index with metabolic syndrome and its components: a cross-sectional analysis of the Fasa adult cohort study in rural Iran
    Negar Ghasemi, Shireen S. Kamil, Elham Maleki, Ali H. Al-Marzoqi, Mehran Rahimlou, Reza Tabrizi
    BMC Endocrine Disorders.2026;[Epub]     CrossRef
Complications
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Global, Regional, and National Temporal Trends in Incidence for Type 2 Diabetes Mellitus Related Chronic Kidney Disease from 1992 to 2021
Yu Cao, Huiting Chen, Hui Liu, Hao Wu, Wei Gao
Diabetes Metab J. 2025;49(4):848-861.   Published online March 11, 2025
DOI: https://doi.org/10.4093/dmj.2024.0593
  • 7,859 View
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  • 3 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Type 2 diabetes mellitus (T2DM) is a major cause of declining renal function.
Methods
Temporal trends in T2DM-related chronic kidney disease (CKD-T2DM) incidence across 204 countries and territories from 1992 to 2021 were analyzed using data from the Global Burden of Disease 2021. The impact of macro-factors (demographic change, age, period, and birth cohort) on CKD-T2DM incidence trends was assessed using decomposition analyses and age-period- cohort modeling, highlighting opportunities to improve incidence and reduce regional disparities.
Results
In 2021, global CKD-T2DM incidence cases reached 2.01 million, a 150.92% increase since 1992, with population growth and aging contributing to 80% of this rise. The age-standardized incidence rate (ASIR) ranged from 15.09 per 100,000 in low sociodemographic index (SDI) regions to 23.07 in high SDI regions. China, India, the United States, and Japan have the most incidence cases, accounted for 69% of incidence cases globally. With 175 countries showing an increasing ASIR trend. Unfavorable trend in ASIR increase were generally found in most high-middle and middle SDI countries, such as China and Mexico (net drift=0.15% and 1.17%, per year). Age-period-cohort analyses indicated a high incidence risk near age 80, with worsening risks for recent periods and birth cohorts, except in high SDI areas.
Conclusion
The CKD-T2DM incidence burden continues to rise globally, with significant variations between countries, posing major global health implications. CKD-T2DM is largely preventable and treatable, warranting greater attention in global health policy, particularly for older populations and in low and middle SDI regions.

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  • Expert perspectives on incorporating glucagon-like peptide-1 receptor agonist in diabetes and chronic kidney disease: challenges and opportunities
    Jean-Michel Halimi, Laurent Fauchier, Alexandre Karras, Chloé Amouyal, Dominique Eladari, Patrick Rossignol, Gabriel Choukroun, Philippe Zaoui, Nicolas Girerd, Samy Hadjadj
    European Journal of Preventive Cardiology.2026; 33(1): 8.     CrossRef
  • Efficacy and safety of novel antidiabetic drugs in patients with type 2 diabetes and chronic kidney disease: a network meta-analysis
    Xiaojian Zhu, Xingjia Wang, Peiru Zhang, Zhuoshi Yang, Na Zhao, Jiameng Li, Yunze Shi, Yichen Zhao, Jian Ma
    Frontiers in Endocrinology.2026;[Epub]     CrossRef
  • 2026 Latin American consensus for the management of patients with hypertension and cardio-renal and metabolic disturbances: endorsed by the Latin American Society of Hypertension, the Iberoamerican Hypertension League, and the World Hypertension League
    Antonio Coca, Ramiro Sánchez, Dora I. Molina de Salazar, Ernesto Peñaherrera, Luis Alcocer, Eduardo Barbosa, Guido Grassi, Patricio Lopez-Jaramillo, Empar Lurbe, José Parra-Carrillo, Agustín J. Ramirez, Josep Redón, Weimar Sebba-Barroso, Andrés Acosta, Da
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  • Frailty and incident diabetes among middle-aged and older adults: Evidence from a large prospective cohort in China
    Yingzhen Gu, Xiaorong Han, Jinxing Liu, Yifan Li, Wei Zhang, Naqiang Lv, Aimin Dang
    Nutrition, Metabolism and Cardiovascular Diseases.2025; 35(10): 104114.     CrossRef
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    Gokhan Koker
    Nephrology.2025;[Epub]     CrossRef
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    Arunita Chatterjee, Sharma S. Prabhakar
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    Fang Luo, Junjie Feng, Jumahan Nverjiang, Jiangnan Ye, Chang Liu, Hanhan Chen, Zhuoxuan Li, Qunwen Lu, Wei Zhang, Furong Zhang, Jun Zhu, Chengguo Su
    Diabetology & Metabolic Syndrome.2025;[Epub]     CrossRef
Metabolic Risk/Epidemiology
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Trends in Metabolically Unhealthy Obesity by Age, Sex, Race/Ethnicity, and Income among United States Adults, 1999 to 2018
Wen Zeng, Weijiao Zhou, Junlan Pu, Juan Li, Xiao Hu, Yuanrong Yao, Shaomei Shang
Diabetes Metab J. 2025;49(3):475-484.   Published online February 25, 2025
DOI: https://doi.org/10.4093/dmj.2024.0364
  • 5,677 View
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  • 5 Web of Science
  • 7 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to estimate temporal trends in metabolically unhealthy obesity (MUO) among United States (US) adults by age, sex, race/ethnicity, and income from 1999 to 2018.
Methods
We included 17,230 non-pregnant adults from a nationally representative cross-sectional study, the National Health and Nutrition Examination Survey (NHANES). MUO was defined as body mass index ≥30 kg/m2 with any metabolic disorders in blood pressure, blood glucose, and blood lipids. The age-adjusted percentage of MUO was calculated, and linear regression models estimated trends in MUO.
Results
The weighted mean age of adults was 47.28 years; 51.02% were male, 74.64% were non-Hispanic White. The age-adjusted percentage of MUO continuously increased in adults across all subgroups during 1999–2018, although with different magnitudes (all P<0.05 for linear trend). Adults aged 45 to 64 years consistently had higher percentages of MUO from 1999–2000 (34.25%; 95% confidence interval [CI], 25.85% to 42.66%) to 2017–2018 (42.03%; 95% CI, 35.09% to 48.97%) than the other two age subgroups (P<0.05 for group differences). The age-adjusted percentage of MUO was the highest among non-Hispanic Blacks while the lowest among non-Hispanic Whites in most cycles. Adults with high-income levels generally had lower MUO percentages from 1999–2000 (22.63%; 95% CI, 17.00% to 28.26%) to 2017–2018 (32.36%; 95% CI, 23.87% to 40.85%) compared with the other two subgroups.
Conclusion
This study detected a continuous linear increasing trend in MUO among US adults from 1999 to 2018. The persistence of disparities by age, race/ethnicity, and income is a cause for concern. This calls for implementing evidence-based, structural, and effective MUO prevention programs.

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    Young Sang Lyu, Sang Yong Kim
    Diabetes & Metabolism Journal.2025; 49(3): 405.     CrossRef
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    Amedeo Lonardo, Ralf Weiskirchen
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    JIANRONG ZHANG
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Review
Others
Article image
Korean National Burden of Disease: The Importance of Diabetes Management
Chung-Nyun Kim, Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
Diabetes Metab J. 2024;48(4):518-530.   Published online July 26, 2024
DOI: https://doi.org/10.4093/dmj.2024.0087
  • 12,469 View
  • 309 Download
  • 18 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Diagnosing the current health status and disease burden in a population is crucial for public health interventions. The ability to compare the burden of different diseases through a single measure, such as disability-adjusted life years has become feasible and continues to be produced and updated through the Global Burden of Diseases (GBD) study. However, the disease burden values of the GBD study do not accurately reflect the unique situation in a specific country with various circumstances. In response, the Korean National Burden of Disease (KNBD) study was conducted to estimate the disease burden in Koreans by considering Korea’s cultural context and utilizing the available data sources at the national level. Both studies identified non-communicable diseases, such as diabetes mellitus (DM), as the primary cause of disease burden among Koreans. However, the extent of public health interventions currently being conducted by the central and local governments does not align with the severity of the disease burden. This review suggests that despite the high burden of DM in South Korea, the current policies may not fully address its impact, underscoring the need for expanded chronic disease management programs and a shift towards prevention-focused healthcare paradigms.

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    Journal of Diabetes Investigation.2025; 16(6): 971.     CrossRef
  • Continuity of care and medication adherence in patients with angina: a retrospective cohort study using Korea’s National Health Insurance data
    Dayea Kim, Jaewoo Cha
    BMJ Open.2025; 15(6): e098903.     CrossRef
  • Effect of smoking cessation on new-onset diabetes mellitus in dyslipidemic individuals: A population-based cohort study
    Wooin Seo, Se Young Jung, KeeHyuck Lee, Woo Kyung Bae, Jong Soo Han, Hyejin Lee, Ji Soo Kim, Hye Yeon Koo, Seung Yeon Lee, Kiheon Lee
    Tobacco Induced Diseases.2025; 23(June): 1.     CrossRef
  • Association between smoking status and suicide mortality in patients with type 2 diabetes: A nationwide population-based cohort study
    Chaiho Jeong, Bongseong Kim, Dae Jong Oh, Tae-Seo Sohn, Kyungdo Han, Hyuk-Sang Kwon
    Diabetes & Metabolism.2025; 51(6): 101692.     CrossRef
  • Case Report on the Improvement of Uncontrolled Blood Glucose with Shihogayonggolmoryo-tang, Yeonggyechulgam-tang, and Korean Medicine Complex Therapy
    Nahyun Cho, Chul-woo Ahn, Hyungsun Jun, Hyun-jong Jung, Dasol Park, Jungtae Leem
    The Journal of Internal Korean Medicine.2025; 46(3): 511.     CrossRef
  • Start Early, Do It Well: Implications of a National Diabetes Care Quality Assessment Program for Life Expectancy
    Kyoung Hwa Ha, Dae Jung Kim
    Diabetes & Metabolism Journal.2025; 49(5): 987.     CrossRef
  • Two decades of diabetes prevention: Sustained benefits, heterogeneous effects, and implications for precision prevention
    Seung‐Hwan Lee
    Journal of Diabetes Investigation.2025; 16(10): 1779.     CrossRef
  • Is the next STEP on the BPROAD to intensive blood pressure lowering for all type 2 diabetic patients?: consensus statements from the Korean Society of Hypertension
    Eun Mi Lee, In-Jeong Cho, Hae Jin Kim, Dae-Hee Kim, Hae-Young Lee, Sungha Park, Sang-Hyun Ihm
    Clinical Hypertension.2025;[Epub]     CrossRef
  • Effect of smoking cessation and post-cessation weight change on suicide mortality in type 2 diabetes: A nationwide cohort study
    Chaiho Jeong, Bongseong Kim, Dae Jong Oh, Tae-Seo Sohn, Kyungdo Han, Hyuk-Sang Kwon
    Diabetes Research and Clinical Practice.2025; 230: 112967.     CrossRef
  • Pharmacoacupuncture for Lowering HbA1c in Korean Adult Patients With Hyperglycemia: A Retrospective Study
    Ju-young Lee, Youngeun Yoo, Sanghun Lee
    Acupuncture & Electro-Therapeutics Research: International Journal of Integrated Medicine.2025; 49(4): 230.     CrossRef
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    Yve Han, Huaxing Lou, Peng Zhao, Hui Li, Congyi Zhang, Hongru Sun
    Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2025; 19(10): 103324.     CrossRef
Original Articles
Cardiovascular Risk/Epidemiology
Article image
Social Determinants of Health and Cardiovascular Risk among Adults with Diabetes: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Lisa Zhang, Evgeniya Reshetnyak, Joanna B. Ringel, Laura C. Pinheiro, April Carson, Doyle M. Cummings, Raegan W. Durant, Gargya Malla, Monika M. Safford
Diabetes Metab J. 2024;48(6):1073-1083.   Published online July 22, 2024
DOI: https://doi.org/10.4093/dmj.2023.0380
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Social determinants of health (SDOH) have been associated with diabetes risk; however, their association with cardiovascular disease (CVD) events in individuals with diabetes is poorly described. We hypothesized that a greater number of SDOH among individuals with diabetes would be associated with a higher risk of CVD events.
Methods
The REasons for Geographic and Racial Differences in Stroke (REGARDS) study is a national, biracial cohort of 30,239 individuals ≥45 years old recruited in 2003–2007. We included 6,322 participants with diabetes at baseline, defined as healthcare professional diagnosis, diabetes medication use, or blood glucose values. Seven SDOH that were individually associated with CVD events were included (P<0.20). The outcome was CVD events, a composite of expert-adjudicated myocardial infarction, stroke, or cardiovascular death. We estimated Cox proportional hazard models to examine associations between number of SDOH (0, 1, 2, ≥3) and CVD events.
Results
In an age and sex adjusted model, the presence of multiple SDOH significantly increased the risk of any CVD event (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.26 to 1.74 for two SDOH; HR, 1.68; 95% CI, 1.43 to 1.96 for ≥3 SDOH). This finding was attenuated but remained statistically significant in a fully adjusted model (HR, 1.19; 95% CI, 1.01 to 1.40 for two SDOH; HR, 1.27; 95% CI, 1.07 to 1.50 for ≥3 SDOH).
Conclusion
Having multiple SDOH was independently associated with an increased risk of CVD events, a finding driven by cardiovascular death. Identifying individuals with diabetes who have multiple SDOH may be helpful for detecting those at higher risk of experiencing or dying from CVD events.

Citations

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  • Tailoring interventions to close gaps in diabetes mellitus care
    Alicia Diaz-Thomas, Susanne Cabrera, Rocio I. Pereira, Pallavi Iyer
    Nature Reviews Endocrinology.2026;[Epub]     CrossRef
  • Social determinants of health and stroke risk: A dose–response analysis of cumulative socioeconomic burden in US adults
    Jianghong Wang, Cailiu Wei, Xiaoyan Hu, Linlin Cai, Sanmeizi Xie
    Neurological Sciences.2026;[Epub]     CrossRef
  • A Case-Based Analysis of Social Drivers in Diabetes Outcomes
    Katherine E. Matics
    The Journal for Nurse Practitioners.2026; 22(5): 105761.     CrossRef
  • The impact of social determinants of health on diabetic gastroparesis: a retrospective analysis
    Ioana Soare, Nicoleta Andreea Tudose, Claudia Simona Stefan, Roxana Elena Mirică
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Hypertriglyceridemic waist phenotype in relation to diabetes mellitus and cardiovascular diseases in the Indonesian and Korean populations: evidence from two national surveys
    Fathimah S. Sigit, Sinyoung Cho, Farid Kurniawan, Hye-Ryeong Jeon, Ratu Ayu Dewi Sartika, Dicky L. Tahapary, Hyuktae Kwon
    Diabetology & Metabolic Syndrome.2025;[Epub]     CrossRef
Metabolic Risk/Epidemiology
Article image
Healthy Lifestyle and the Risk of Metabolic Dysfunction-Associated Fatty Liver Disease: A Large Prospective Cohort Study
Qing Chang, Yixiao Zhang, Tingjing Zhang, Zuyun Liu, Limin Cao, Qing Zhang, Li Liu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Yang Ding, Yuhong Zhao, Kaijun Niu, Yang Xia
Diabetes Metab J. 2024;48(5):971-982.   Published online March 19, 2024
DOI: https://doi.org/10.4093/dmj.2023.0133
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The incidence density of metabolic dysfunction-associated fatty liver disease (MAFLD) and the effect of a healthy lifestyle on the risk of MAFLD remain unknown. We evaluated the prevalence and incidence density of MAFLD and investigated the association between healthy lifestyle and the risk of MAFLD.
Methods
A cross-sectional analysis was conducted on 37,422 participants to explore the prevalence of MAFLD. A cohort analysis of 18,964 individuals was conducted to identify the incidence of MAFLD, as well as the association between healthy lifestyle and MAFLD. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) with adjustments for confounding factors.
Results
The prevalence of MAFLD, non-alcoholic fatty liver disease, and their comorbidities were 30.38%, 28.09%, and 26.13%, respectively. After approximately 70 thousand person-years of follow-up, the incidence densities of the three conditions were 61.03, 55.49, and 51.64 per 1,000 person-years, respectively. Adherence to an overall healthy lifestyle was associated with a 19% decreased risk of MAFLD (HR, 0.81; 95% CI, 0.72 to 0.92), and the effects were modified by baseline age, sex, and body mass index (BMI). Subgroup analyses revealed that younger participants, men, and those with a lower BMI experienced more significant beneficial effects from healthy lifestyle.
Conclusion
Our results highlight the beneficial effect of adherence to a healthy lifestyle on the prevention of MAFLD. Health management for improving dietary intake, physical activity, and smoking and drinking habits are critical to improving MAFLD.

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  • The Role of Kupffer Cells and Liver Macrophages in the Pathogenesis of Metabolic Dysfunction-Associated Steatotic Liver Disease
    Ioannis Tsomidis, Angeliki Tsakou, Argyro Voumvouraki, Elias Kouroumalis
    Biomedicines.2026; 14(1): 151.     CrossRef
  • Impact of healthy lifestyles on the risk of metabolic dysfunction‐associated steatotic liver disease among adults with comorbid hypertension and diabetes: Novel insight from a largely middle‐aged and elderly cohort in South China
    Jun‐Yan Xi, Yi‐Jing Wang, Xiao‐Heng Li, Nuo‐Min Sun, Rui‐Qi Ming, Hua‐Ling Yan, Huan‐Le Cai, Jian‐Jun Bai, Yi‐Ning Xiang, Jing Gu, Xiao Lin, Gang Liu, Yuan‐Tao Hao
    Diabetes, Obesity and Metabolism.2025; 27(5): 2800.     CrossRef
  • Cholesteryl ester transfer protein gene variants and metabolic dysfunction-associated steatotic liver disease: genetic associations with steatosis in obese and lean individuals
    Asmaa AbdelFattah, Mahmoud Kattab, Hosny Abdel Ghany, Lamiaa Aly, Ahmed Mady, Aly Hamdi, Riham Soliman, Gamal Shiha, Nada El-Domiaty
    Egyptian Liver Journal.2025;[Epub]     CrossRef
  • Research trends on the quality of life in patients with metabolic dysfunction-associated fatty liver diseases: a scientific metrology study
    Can Huang, Meng Chen, Yanfang Sun, Lin Zhang, Wei Liu
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • The relationship between tobacco and non-alcoholic fatty liver disease incidence: a systematic review and meta-analysis of observational studies
    Jianxiang Jin, Yuping Zhang, Yiping Huang
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • Enhancing MAFLD Care: Efficacy of a Multidisciplinary Community Intervention on Self-Management and Hepatic Outcomes
    Huan-Jing Cai, Hai-Lun Liang, Lei-Yu Shi, Yi-Hui Rong, Jing Li, Yan Zhang, Rui-Fang Ma
    INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2025;[Epub]     CrossRef
  • Mechanistic investigation of DDT/DDE in MASLD/MASH pathogenesis: An integrated network toxicology and transcriptomics approach
    Yicheng Jiang, Yuancheng Shao, Jiaming Xue, Zhigang Chen, Qi Liu, Shuai Chen, Xihan Gu, Shufan Zhang, Liming Tang
    Ecotoxicology and Environmental Safety.2025; 307: 119390.     CrossRef
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    Wenhua Bai, Zheng Zhu
    Frontiers in Endocrinology.2025;[Epub]     CrossRef
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    Tianzhu Chen, Xiang Qin, Jianping Jiang, Beihui He
    Frontiers in Nutrition.2024;[Epub]     CrossRef
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    Tatjana Ábel, Béla Benczúr, Éva Csajbókné Csobod
    Frontiers in Medicine.2024;[Epub]     CrossRef
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    Jialu Yang, Qi Zhang, Wanying Zhao, Bingqi Ye, Siqi Li, Zhuoyu Zhang, Jingmeng Ju, Jialin He, Min Xia, Tiantian Xiong, Yan Liu
    Nutrition & Diabetes.2024;[Epub]     CrossRef
Lifestyle
Article image
Enhancing Diabetes Care through a Mobile Application: A Randomized Clinical Trial on Integrating Physical and Mental Health among Disadvantaged Individuals
Jae Hyun Bae, Eun Hee Park, Hae Kyung Lee, Kun Ho Yoon, Kyu Chang Won, Hyun Mi Kim, Sin Gon Kim
Diabetes Metab J. 2024;48(4):790-801.   Published online February 2, 2024
DOI: https://doi.org/10.4093/dmj.2023.0298
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study examines integrating physical and mental healthcare for disadvantaged persons with type 2 diabetes mellitus and mild-to-moderate depression in the community, using a mobile application within a public-private-academic partnership.
Methods
The Korean Diabetes Association has developed a mobile application combining behavioral activation for psychological well-being and diabetes self-management, with conventional medical therapy. Participants were randomly assigned to receive the application with usual care or only usual care. Primary outcomes measured changes in psychological status and diabetes selfmanagement through questionnaires at week 12 from the baseline. Secondary outcomes assessed glycemic and lipid control, with psychological assessments at week 16.
Results
Thirty-nine of 73 participants completed the study (20 and 19 in the intervention and control groups, respectively) and were included in the analysis. At week 12, the intervention group showed significant reductions in depression severity and perceived stress compared to the control group. Additionally, they reported increased perceived social support and demonstrated improved diabetes self-care behavior. These positive effects persisted through week 16, with the added benefit of reduced anxiety. While fasting glucose levels in the intervention group tended to improve, no other significant differences were observed in laboratory assessments between the groups.
Conclusion
This study provides compelling evidence for the potential efficacy of a mobile application that integrates physical and mental health components to address depressive symptoms and enhance diabetes self-management in disadvantaged individuals with type 2 diabetes mellitus and depression. Further research involving larger and more diverse populations is warranted to validate these findings and solidify their implications.

Citations

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  • Effectiveness of online social support interventions for psychological distress: A three-level meta-analysis of randomized controlled trials
    Rui Li, Xinyi Liu, Siyao Jia, Lizu Lai, Xiaopeng Lu, Qian Xiong, Weixin Cheng, Sihan Liu, Ruowen Xu, Yanqi Chen, Jiao Li, Zhihong Ren
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    Seohyun Kim, Minkyeong Kim, Sang Ho Park, Soojin Park, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim, Gyuri Kim
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    Kyunghun Sung, Seung‐Hwan Lee
    Journal of Diabetes Investigation.2025; 16(6): 971.     CrossRef
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    Shinae Kang, Seon Mee Kang, Jong Han Choi, Seung-Hyun Ko, Bo Kyung Koo, Hyuk-Sang Kwon, Mi Kyung Kim, Sang Yong Kim, Soo-Kyung Kim, Young-eun Kim, Eun Sook Kim, Jae Hyeon Kim, Chong Hwa Kim, Ji Min Kim, Hae Jin Kim, Min Kyong Moon, Sun Joon Moon, Jun Sung
    Diabetes & Metabolism Journal.2025; 49(4): 582.     CrossRef
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    Eduard Xavier Montesinos-Sansaloni, Domingo Ribeiro-Soriano, Dolores Botella-Carrubi
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    Xinyi Liu, Rui Li, Lizu Lai, Xiaopeng Lu, Siyao Jia, Qian Xiong, Weixin Cheng, Ruowen Xu, Yanqi Chen, Jiao Li, Yuyi Zhang, Yunhui Zhong, Mingchun Guo, Zhihong Ren
    Applied Psychology: Health and Well-Being.2025;[Epub]     CrossRef
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    Xiaohong Xu, Fang Wang, Shunqi Liao, Jingxian Liu, Lingyi Xiao
    Journal of Medical Internet Research.2025; 27: e80476.     CrossRef
Cardiovascular risk/Epidemiology
Article image
Real-World Treatment Patterns according to Clinical Practice Guidelines in Patients with Type 2 Diabetes Mellitus and Established Cardiovascular Disease in Korea: Multicenter, Retrospective, Observational Study
Ye Seul Yang, Nam Hoon Kim, Jong Ha Baek, Seung-Hyun Ko, Jang Won Son, Seung-Hwan Lee, Sang Youl Rhee, Soo-Kyung Kim, Tae Seo Sohn, Ji Eun Jun, In-Kyung Jeong, Chong Hwa Kim, Keeho Song, Eun-Jung Rhee, Junghyun Noh, Kyu Yeon Hur, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2024;48(2):279-289.   Published online January 26, 2024
DOI: https://doi.org/10.4093/dmj.2023.0225
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Recent diabetes management guidelines recommend that sodium-glucose cotransporter 2 inhibitors (SGLT2is) or glucagon-like peptide 1 receptor agonists (GLP-1RAs) with proven cardiovascular benefits should be prioritized for combination therapy in patients with type 2 diabetes mellitus (T2DM) and established cardiovascular disease (CVD). This study was aimed at evaluating SGLT2i or GLP-1RA usage rates and various related factors in patients with T2DM and established CVD.
Methods
We enrolled adults with T2DM aged ≥30 years who were hospitalized due to established CVD from January 2019 to May 2020 at 13 secondary and tertiary hospitals in Korea in this retrospective observational study.
Results
Overall, 2,050 patients were eligible for analysis among 2,107 enrolled patients. The mean patient age, diabetes duration, and glycosylated hemoglobin level were 70.0 years, 12.0 years, and 7.5%, respectively. During the mean follow-up duration of 9.7 months, 25.7% of the patients were prescribed SGLT2is after CVD events. However, only 1.8% were prescribed GLP-1RAs. Compared with SGLT2i non-users, SGLT2i users were more frequently male and obese. Furthermore, they had a shorter diabetes duration but showed worse glycemic control and better renal function at the time of the event. GLP-1RA users had a longer duration of diabetes and worse glycemic control at the time of the event than GLP-1RA non-users.
Conclusion
The SGLT2i or GLP-1RA prescription rates were suboptimal in patients with T2DM and established CVD. Sex, body mass index, diabetes duration, glycemic control, and renal function were associated with the use of these agents.

Citations

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    Latha P. Palaniappan, Norrina B. Allen, Zaid I. Almarzooq, Cheryl A.M. Anderson, Pankaj Arora, Christy L. Avery, Carissa M. Baker-Smith, Nisha Bansal, Maria E. Currie, Rebecca S. Earlie, Wenjun Fan, Jessica L. Fetterman, Bethany Barone Gibbs, Debra G. Hea
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    Jin Hwa Kim, Junyeop Lee, Kyungdo Han, Jae-Taek Kim, Hyuk-Sang Kwon
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Guideline/Fact Sheet
Article image
Dyslipidemia Fact Sheet in South Korea, 2022
Eun-Sun Jin, Jee-Seon Shim, Sung Eun Kim, Jae Hyun Bae, Shinae Kang, Jong Chul Won, Min-Jeong Shin, Heung Yong Jin, Jenny Moon, Hokyou Lee, Hyeon Chang Kim, In-Kyung Jeong, on Behalf of the Committee of Public Relation of the Korean Society of Lipid and Atherosclerosis
Diabetes Metab J. 2023;47(5):632-642.   Published online August 2, 2023
DOI: https://doi.org/10.4093/dmj.2023.0135
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to investigate the prevalence and status of dyslipidemia management among South Korean adults, as performed by the Korean Society of Lipid and Atherosclerosis under the name Dyslipidemia Fact Sheet 2022.
Methods
We analyzed the lipid profiles, age-standardized and crude prevalence, management status of hypercholesterolemia and dyslipidemia, and health behaviors among Korean adults aged ≥20 years, using the Korea National Health and Nutrition Examination Survey data between 2007 and 2020.
Results
In South Korea, the crude prevalence of hypercholesterolemia (total cholesterol ≥240 mg/dL or use of a lipid-lowering drug) in 2020 was 24%, and the age-standardized prevalence of hypercholesterolemia more than doubled from 2007 to 2020. The crude treatment rate was 55.2%, and the control rate was 47.7%. The crude prevalence of dyslipidemia—more than one out of three conditions (low-density lipoprotein cholesterol ≥160 or the use of a lipid-lowering drug, triglycerides ≥200, or high-density lipoprotein cholesterol [HDL-C] [men and women] <40 mg/dL)—was 40.2% between 2016 and 2020. However, it increased to 48.2% when the definition of hypo-HDL-cholesterolemia in women changed from <40 to <50 mg/dL.
Conclusion
Although the prevalence of hypercholesterolemia and dyslipidemia has steadily increased in South Korea, the treatment rate remains low. Therefore, continuous efforts are needed to manage dyslipidemia through cooperation between the national healthcare system, patients, and healthcare providers.

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Guideline/Fact Sheet
Article image
Comparison of Operational Definition of Type 2 Diabetes Mellitus Based on Data from Korean National Health Insurance Service and Korea National Health and Nutrition Examination Survey
Jong Ha Baek, Yong-Moon Park, Kyung Do Han, Min Kyong Moon, Jong Han Choi, Seung-Hyun Ko
Diabetes Metab J. 2023;47(2):201-210.   Published online February 8, 2023
DOI: https://doi.org/10.4093/dmj.2022.0375
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
We evaluated the validity and reliability of the operational definition of type 2 diabetes mellitus (T2DM) based on the Korean National Health Insurance Service (NHIS) database.
Methods
Adult subjects (≥40 years old) included in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2017 were merged with those from the NHIS health check-up database, producing a cross-sectional dataset. We evaluated the sensitivity, specificity, accuracy, and agreement of the NHIS criteria for defining T2DM by comparing them with the KNHANES criteria as a standard reference.
Results
In the study population (n=13,006), two algorithms were devised to determine from the NHIS dataset whether the diagnostic claim codes for T2DM were accompanied by prescription codes for anti-diabetic drugs (algorithm 1) or not (algorithm 2). Using these algorithms, the prevalence of T2DM was 14.9% (n=1,942; algorithm 1) and 20.8% (n=2,707; algorithm 2). Good reliability in defining T2DM was observed for both algorithms (Kappa index, 0.73 [algorithm 1], 0.63 [algorithm 2]). However, the accuracy (0.93 vs. 0.89) and specificity (0.96 vs. 0.90) tended to be higher for algorithm 1 than for algorithm 2. The validity (accuracy, ranging from 0.91 to 0.95) and reliability (Kappa index, ranging from 0.68 to 0.78) of defining T2DM by NHIS criteria were independent of age, sex, socioeconomic status, and accompanied hypertension or dyslipidemia.
Conclusion
The operational definition of T2DM based on population-based NHIS claims data, including diagnostic codes and prescription codes, could be a valid tool to identify individuals with T2DM in the Korean population.

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Review
Others
Article image
Current Trends of Big Data Research Using the Korean National Health Information Database
Mee Kyoung Kim, Kyungdo Han, Seung-Hwan Lee
Diabetes Metab J. 2022;46(4):552-563.   Published online July 27, 2022
DOI: https://doi.org/10.4093/dmj.2022.0193
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AbstractAbstract PDFPubReader   ePub   
Recently, medical research using big data has become very popular, and its value has become increasingly recognized. The Korean National Health Information Database (NHID) is representative of big data that combines information obtained from the National Health Insurance Service collected for claims and reimbursement of health care services and results obtained from general health examinations provided to all Korean adults. This database has several strengths and limitations. Given the large size, various laboratory data, and questionnaires obtained from medical check-ups, their longitudinal nature, and long-term accumulation of data since 2002, carefully designed studies may provide valuable information that is difficult to obtain from other forms of research. However, consideration of possible bias and careful interpretation when defining causal relationships is also important because the data were not collected for research purposes. After the NHID became publicly available, research and publications based on this database have increased explosively, especially in the field of diabetes and metabolism. This article reviews the history, structure, and characteristics of the Korean NHID. Recent trends in big data research using this database, commonly used operational diagnosis, and representative studies have been introduced. We expect further progress and expansion of big data research using the Korean NHID.

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Original Articles
Drug/Regimen
Article image
Real-World Prescription Patterns and Barriers Related to the Use of Sodium-Glucose Cotransporter 2 Inhibitors among Korean Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease
Jong Ha Baek, Ye Seul Yang, Seung-Hyun Ko, Kyung Do Han, Jae Hyeon Kim, Min Kyong Moon, Jong Suk Park, Byung-Wan Lee, Tae Jung Oh, Suk Chon, Jong Han Choi, Kyu Yeon Hur, Committee of Clinical Practice Guidelines, Korean Diabetes Association
Diabetes Metab J. 2022;46(5):701-712.   Published online June 3, 2022
DOI: https://doi.org/10.4093/dmj.2022.0002
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
To evaluate prescription trends and clinical factors of the sodium-glucose cotransporter 2 inhibitors (SGLT2i) use according to the presence of atherosclerotic cardiovascular disease (ASCVD) or heart failure (HF) in Korean patients with type 2 diabetes mellitus (T2DM).
Methods
Prescription patterns of SGLT2i use between 2015 and 2019 were determined using the Korean National Health Insurance Service database of claims.
Results
Of all patients with T2DM (n=4,736,493), the annual prescription rate of SGLT2i increased every year in patients with ASCVD (from 2.2% to 10.7%) or HF (from 2.0% to 11.1%). After the first hospitalization for ASCVD (n=518,572), 13.7% (n=71,259) of patients initiated SGLT2i with a median of 10.6 months. After hospitalization for HF (n=372,853), 11.2% (n=41,717) of patients initiated SGLT2i after a median of 8.8 months. In multivariate regression for hospitalization, older age (per 10 years, odds ratio [OR], 0.57; 95% confidence interval [CI], 0.56 to 0.57), lower household income (OR, 0.93; 95% CI, 0.92 to 0.95), rural residents (OR, 0.95; 95% CI, 0.93 to 0.97), and dipeptidyl peptidase-4 inhibitor (DPP-4i) users (OR, 0.82; 95% CI, 0.81 to 0.84) were associated with lesser initiation of SGLT2i in ASCVD. Additionally, female gender (OR, 0.97; 95% CI, 0.95 to 0.99) was associated with lesser initiation of SGLT2i in HF.
Conclusion
The prescription rate of SGLT2i increased gradually up to 2019 but was suboptimal in patients with ASCVD or HF. After the first hospitalization for ASCVD or HF, older age, female gender, low household income, rural residents, and DPP-4i users were less likely to initiate SGLT2i.

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Guideline/Fact Sheet
Article image
Diabetes Fact Sheet in Korea 2021
Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won, on Behalf of the Committee of Media-Public Relation of the Korean Diabetes Association
Diabetes Metab J. 2022;46(3):417-426.   Published online May 25, 2022
DOI: https://doi.org/10.4093/dmj.2022.0106
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to investigate the prevalence and management of diabetes mellitus, risk-factor control, and comorbidities among Korean adults.
Methods
We conducted a cross-sectional analysis of data from the Korea National Health and Nutrition Examination Survey to assess the prevalence, treatment, risk factors, comorbidities, and self-management behaviors of diabetes mellitus from 2019 to 2020. We also analyzed data from the Korean National Health Insurance Service to evaluate the use of antidiabetic medications in people with diabetes mellitus from 2002 through 2018.
Results
Among Korean adults aged 30 years or older, the estimated prevalence of diabetes mellitus was 16.7% in 2020. From 2019 through 2020, 65.8% of adults with diabetes mellitus were aware of the disease and treated with antidiabetic medications. The percentage of adults with diabetes mellitus who achieved glycosylated hemoglobin (HbA1c) <6.5% was 24.5% despite the increased use of new antidiabetic medications. We found that adults with diabetes mellitus who achieved all three goals of HbA1c <6.5%, blood pressure (BP) <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL were 9.7%. The percentage of self-management behaviors was lower in men than women. Excess energy intake was observed in 16.7% of adults with diabetes mellitus.
Conclusion
The prevalence of diabetes mellitus among Korean adults remained high. Only 9.7% of adults with diabetes mellitus achieved all glycemic, BP, and lipid controls from 2019 to 2020. Continuous evaluation of national diabetes statistics and a national effort to increase awareness of diabetes mellitus and improve comprehensive diabetes care are needed.

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Others
Development of Various Diabetes Prediction Models Using Machine Learning Techniques
Juyoung Shin, Jaewon Kim, Chanjung Lee, Joon Young Yoon, Seyeon Kim, Seungjae Song, Hun-Sung Kim
Diabetes Metab J. 2022;46(4):650-657.   Published online March 11, 2022
DOI: https://doi.org/10.4093/dmj.2021.0115
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
There are many models for predicting diabetes mellitus (DM), but their clinical implication remains vague. Therefore, we aimed to create various DM prediction models using easily accessible health screening test parameters.
Methods
Two sets of variables were used to develop eight DM prediction models. One set comprised 62 easily accessible examination results of commonly used variables from a tertiary university hospital. The second set comprised 27 of the 62 variables included in the national routine health checkups. Gradient boosting and random forest algorithms were used to develop the models. Internal validation was performed using the stratified 10-fold cross-validation method.
Results
The area under the receiver operating characteristic curve (ROC-AUC) for the 62-variable DM model making 12-month predictions for subjects without diabetes was the largest (0.928) among those of the eight DM prediction models. The ROC-AUC dropped by more than 0.04 when training with the simplified 27-variable set but still showed fairly good performance with ROC-AUCs between 0.842 and 0.880. The accuracy was up to 11.5% higher (from 0.807 to 0.714) when fasting glucose was included.
Conclusion
We created easily applicable diabetes prediction models that deliver good performance using parameters commonly assessed during tertiary university hospital and national routine health checkups. We plan to perform prospective external validation, hoping that the developed DM prediction models will be widely used in clinical practice.

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Brief Report
Complications
Article image
Status of Diabetic Neuropathy in Korea: A National Health Insurance Service-National Sample Cohort Analysis (2006 to 2015)
Seong-Su Moon, Chong Hwa Kim, Seon Mee Kang, Eun Sook Kim, Tae Jung Oh, Jae-Seung Yun, Ho Chan Cho, Dae Jung Kim, Tae Sun Park
Diabetes Metab J. 2021;45(1):115-119.   Published online December 18, 2020
DOI: https://doi.org/10.4093/dmj.2020.0120
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  • 17 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
This report presents the status of diabetic neuropathy (DN) in Korea as determined using a National Health Insurance ServiceNational Sample Cohort (NHIS-NSC). Annual prevalences of DN were estimated by age and gender using descriptive statistics. Pharmacological treatments for DN were also analyzed. The annual prevalence of DN increased from 24.9% in 2006 to 26.6% in 2007, and thereafter, gradually subsided to 20.8% in 2015. In most cases, pharmacological treatments involved a single drug, which accounted for 91.6% of total prescriptions in 2015. The most commonly used drugs (in decreasing order) were thioctic acid, an anti-convulsive agent, or a tricyclic antidepressant. In conclusion, the prevalence of DN decreased over the 10-year study period. Thioctic acid monotherapy was usually prescribed for DN. To reduce the socio-economic burden of DN, more attention should be paid to the diagnosis of this condition and to the appropriate management of patients.

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Original Article
Technology/Device
Article image
Data Configuration and Publication Trends for the Korean National Health Insurance and Health Insurance Review & Assessment Database
Hae Kyung Kim, Sun Ok Song, Junghyun Noh, In-Kyung Jeong, Byung-Wan Lee
Diabetes Metab J. 2020;44(5):671-678.   Published online October 21, 2020
DOI: https://doi.org/10.4093/dmj.2020.0207
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AbstractAbstract PDFPubReader   ePub   
Background
Big data reports related to diseases and health care for the Korean population have been published since the National Health Insurance Service (NHIS) and the Health Insurance Review & Assessment (HIRA) Service provided limited open access to their databases. Here, we reviewed the structure, content, and means of using data from the National Health Insurance (NHI) system for the benefit of Korean researchers and presented the latest publication trends in Korean healthcare data procured from the NHI and HIRA databases.
Methods
Since 2013, researchers have been able to obtain nationwide population-based studies using the NHI and HIRA databases of the insured. We searched publications using the NHI and the HIRA databases between 2013 and 2019 retrieved from PubMed.
Results
The NHI and HIRA databases provide nationwide population-based data. The total number of publications from 2014 to 2019 using NHI and HIRA databases is 2,541 and 655, respectively. A total of 5,465 endocrinology-related studies were performed during 2014 to 2019.
Conclusion
The NHIS and HIRA databases have provided tools for guidelines to approach world-leading population-based epidemiology and disease research.

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Review
Others
Mitochondrial Toxins and Healthy Lifestyle Meet at the Crossroad of Hormesis
Yu-Mi Lee, Duk-Hee Lee
Diabetes Metab J. 2019;43(5):568-577.   Published online October 24, 2019
DOI: https://doi.org/10.4093/dmj.2019.0143
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AbstractAbstract PDFPubReader   ePub   

Mitochondrial function is crucial for the maintenance of cellular homeostasis under physiological and stress conditions. Thus, chronic exposure to environmental chemicals that affect mitochondrial function can have harmful effects on humans. We argue that the concept of hormesis should be revisited to explain the non-linear responses to mitochondrial toxins at a low-dose range and develop practical methods to protect humans from the negative effects of mitochondrial toxins. Of the most concern to humans are lipophilic chemical mixtures and heavy metals, owing to their physical properties. Even though these chemicals tend to demonstrate no safe level in humans, a non-linear dose-response has been also observed. Stress response activation, i.e., hormesis, can explain this non-linearity. Recently, hormesis has reemerged as a unifying concept because diverse stressors can induce similar stress responses. Besides potentially harmful environmental chemicals, healthy lifestyle interventions such as exercise, calorie restriction (especially glucose), cognitive stimulation, and phytochemical intake also activate stress responses. This conceptual link can lead to the development of practical methods that counterbalance the harm of mitochondrial toxins. Unlike chemical hormesis with its safety issues, the activation of stress responses via lifestyle modification can be safely used to combat the negative effects of mitochondrial toxins.

Citations

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Original Articles
Drug/Regimen
An Electronic Health Record-Integrated Computerized Intravenous Insulin Infusion Protocol: Clinical Outcomes and in Silico Adjustment
Sung Woon Park, Seunghyun Lee, Won Chul Cha, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee, Sung-Min Park, Sang-Man Jin
Diabetes Metab J. 2020;44(1):56-66.   Published online October 21, 2019
DOI: https://doi.org/10.4093/dmj.2018.0227
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  • 2 Web of Science
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

We aimed to describe the outcome of a computerized intravenous insulin infusion (CII) protocol integrated to the electronic health record (EHR) system and to improve the CII protocol in silico using the EHR-based predictors of the outcome.

Methods

Clinical outcomes of the patients who underwent the CII protocol between July 2016 and February 2017 and their matched controls were evaluated. In the CII protocol group (n=91), multivariable binary logistic regression analysis models were used to determine the independent associates with a delayed response (taking ≥6.0 hours for entering a glucose range of 70 to 180 mg/dL). The CII protocol was adjusted in silico according to the EHR-based parameters obtained in the first 3 hours of CII.

Results

Use of the CII protocol was associated with fewer subjects with hypoglycemia alert values (P=0.003), earlier (P=0.002), and more stable (P=0.017) achievement of a glucose range of 70 to 180 mg/dL. Initial glucose level (P=0.001), change in glucose during the first 2 hours (P=0.026), and change in insulin infusion rate during the first 3 hours (P=0.029) were independently associated with delayed responses. Increasing the insulin infusion rate temporarily according to these parameters in silico significantly reduced delayed responses (P<0.0001) without hypoglycemia, especially in refractory patients.

Conclusion

Our CII protocol enabled faster and more stable glycemic control than conventional care with minimized risk of hypoglycemia. An EHR-based adjustment was simulated to reduce delayed responses without increased incidence of hypoglycemia.

Citations

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  • Response: An Electronic Health Record-Integrated Computerized Intravenous Insulin Infusion Protocol: Clinical Outcomes and in Silico Adjustment (Diabetes Metab J 2020;44:56–66)
    Sung Woon Park, Seunghyun Lee, Won Chul Cha, Kyu Yeon Hur, Jae Hyeon Kim, Moon-Kyu Lee, Sung-Min Park, Sang-Man Jin
    Diabetes & Metabolism Journal.2020; 44(2): 358.     CrossRef
  • Letter: An Electronic Health Record-Integrated Computerized Intravenous Insulin Infusion Protocol: Clinical Outcomes and in Silico Adjustment (Diabetes Metab J 2020;44:56–66)
    Dongwon Yi
    Diabetes & Metabolism Journal.2020; 44(2): 354.     CrossRef
Epidemiology
Article image
Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status
Bo-Yeon Kim, Jong Chul Won, Jae Hyuk Lee, Hun-Sung Kim, Jung Hwan Park, Kyoung Hwa Ha, Kyu Chang Won, Dae Jung Kim, Kyong Soo Park
Diabetes Metab J. 2019;43(4):487-494.   Published online July 17, 2019
DOI: https://doi.org/10.4093/dmj.2019.0067
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  • 112 Web of Science
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AbstractAbstract PDFPubReader   ePub   
Background

The objective of this study was to investigate the prevalence, management, and comorbidities of diabetes among Korean adults aged 30 years and older.

Methods

This study used 2013 to 2016 data from the Korea National Health and Nutrition Examination Survey, a nationally-representative survey of the Korean population. Diabetes was defined as fasting glucose ≥126 mg/dL, current use of antidiabetic medication, a previous history of diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%.

Results

In 2016, 14.4% (approximately 5.02 million) of Korean adults had diabetes. The prevalence of impaired fasting glucose was 25.3% (8.71 million). From 2013 to 2016, the awareness, control, and treatment rates for diabetes were 62.6%, 56.7%, and 25.1%, respectively. People with diabetes had the following comorbidities: obesity (50.4%), abdominal obesity (47.8%), hypertension (55.3%), and hypercholesterolemia (34.9%). The 25.1%, 68.4%, and 44.2% of people with diabetes achieved HbA1c <6.5%, blood pressure <140/85 mm Hg, and low density lipoprotein cholesterol <100 mg/dL. Only 8.4% of people with diabetes had good control of all three targets.

Conclusion

This study confirms that diabetes is as an important public health problem. Efforts should be made to increase awareness, detection, and comprehensive management of diabetes to reduce diabetes-related morbidity and mortality.

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  • The effects of climate on the incidence of benign paroxysmal positional vertigo
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  • Hepatocellular Carcinoma in Korea between 2012 and 2014: an Analysis of Data from the Korean Nationwide Cancer Registry
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  • Effect of Switching from Linagliptin to Teneligliptin Dipeptidyl Peptidase-4 Inhibitors in Older Patients with Type 2 Diabetes Mellitus


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    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 4113.     CrossRef
  • Temperature Correction to Enhance Blood Glucose Monitoring Accuracy Using Electrical Impedance Spectroscopy
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    International Journal of Environmental Research and Public Health.2020; 17(23): 9058.     CrossRef
  • The triglyceride-glucose index predicts ischemic heart disease risk in Koreans: a prospective study using National Health Insurance Service data
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  • Does Diabetes Increase the Risk of Contracting COVID-19? A Population-Based Study in Korea
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  • Independent Impact of Diabetes on the Severity of Coronavirus Disease 2019 in 5,307 Patients in South Korea: A Nationwide-Cohort Study (Diabetes Metab J 2020;44:737-46)
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Epidemiology
Relation between Baseline Height and New Diabetes Development: A Nationwide Population-Based Study
Eun-Jung Rhee, Jung-Hwan Cho, Hyemi Kwon, Se-Eun Park, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Won-Young Lee
Diabetes Metab J. 2019;43(6):794-803.   Published online March 22, 2019
DOI: https://doi.org/10.4093/dmj.2018.0184
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AbstractAbstract PDFPubReader   ePub   
Background

Short stature and leg length are associated with risk of diabetes and obesity. However, it remains unclear whether this association is observed in Asians. We evaluated the association between short stature and increased risk for diabetes using the Korean National Health Screening (KNHS) dataset.

Methods

We assessed diabetes development in 2015 in 21,122,422 non-diabetic Koreans (mean age 43 years) enrolled in KNHS from 2009 to 2012 using International Classification of Diseases 10th (ICD-10) code and anti-diabetic medication prescription. Risk was measured in age- and sex-dependent quintile groups of baseline height (20 to 39, 40 to 59, ≥60 years).

Results

During median 5.6-year follow-up, 532,918 cases (2.5%) of diabetes occurred. The hazard ratio (HR) for diabetes development gradually increased from the 5th (reference) to 1st quintile group of baseline height after adjustment for confounding factors (1.000, 1.076 [1.067 to 1.085], 1.097 [1.088 to 1.107], 1.141 [1.132 to 1.151], 1.234 [1.224 to 1.244]), with similar results in analysis by sex. The HR per 5 cm height increase was lower than 1.00 only in those with fasting blood glucose (FBG) below 100 mg/dL (0.979 [0.975 to 0.983]), and in lean individuals (body mass index [BMI] 18.5 to 23 kg/m2: 0.993 [0.988 to 0.998]; BMI <18.5 kg/m2: 0.918 [0.9 to 0.935]).

Conclusion

Height was inversely associated with diabetes risk in this nationwide study of Korean adults. This association did not differ by sex, and was significant in lean individuals and those with normal FBG levels.

Citations

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Obesity and Metabolic Syndrome
The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
Diabetes Metab J. 2019;43(2):206-221.   Published online December 27, 2018
DOI: https://doi.org/10.4093/dmj.2018.0039
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Waist circumference (WC) is a well-known obesity index that predicts cardiovascular disease (CVD). We studied the relationship between baseline WC and development of incident myocardial infarction (MI) and ischemic stroke (IS) using a nationwide population-based cohort, and evaluated if its predictability is better than body mass index (BMI).

Methods

Our study included 21,749,261 Koreans over 20 years of age who underwent the Korean National Health Screening between 2009 and 2012. The occurrence of MI or IS was investigated until the end of 2015 using National Health Insurance Service data.

Results

A total of 127,289 and 181,637 subjects were newly diagnosed with MI and IS. The incidence rate and hazard ratio of MI and IS increased linearly as the WC level increased, regardless of adjustment for BMI. When the analyses were performed according to 11 groups of WC, the lowest risk of MI was found in subjects with WC of 70 to 74.9 and 65 to 69.9 cm in male and female, and the lowest risk of IS in subjects with WC of 65 to 69.9 and 60 to 64.9 cm in male and female, respectively. WC showed a better ability to predict CVD than BMI with smaller Akaike information criterion. The optimal WC cutoffs were 84/78 cm for male/female for predicting MI, and 85/78 cm for male/female for predicting IS.

Conclusion

WC had a significant linear relationship with the risk of MI and IS and the risk began to increase from a WC that was lower than expected.

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Epidemiology
Article image
Diabetes Fact Sheet in Korea, 2016: An Appraisal of Current Status
Jong Chul Won, Jae Hyuk Lee, Jae Hyeon Kim, Eun Seok Kang, Kyu Chang Won, Dae Jung Kim, Moon-Kyu Lee
Diabetes Metab J. 2018;42(5):415-424.   Published online August 9, 2018
DOI: https://doi.org/10.4093/dmj.2018.0017
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
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.

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Review
Clinical Diabetes & Therapeutics
Article image
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 Metab J. 2018;42(2):93-100.   Published online April 19, 2018
DOI: https://doi.org/10.4093/dmj.2018.42.2.93
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AbstractAbstract PDFPubReader   ePub   

Korea's National Healthcare Program, the National Health Insurance Service (NHIS), a government-affiliated agency under the Korean Ministry of Health and Welfare, covers the entire Korean population. The NHIS supervises all medical services in Korea and establishes a systematic National Health Information database (DB). A health information DB system including all of the claims, medications, death information, and health check-ups, both in the general population and in patients with various diseases, is not common worldwide. On June 9, 2014, the NHIS signed a memorandum of understanding with the Korean Diabetes Association (KDA) to provide limited open access to its DB. By October 31, 2017, seven papers had been published through this collaborative research project. These studies were conducted to investigate the past and current status of type 2 diabetes mellitus and its complications and management in Korea. This review is a brief summary of the collaborative projects between the KDA and the NHIS over the last 3 years. According to the analysis, the national health check-up DB or claim DB were used, and the age category or study period were differentially applied.

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Original Articles
Clinical Care/Education
Improvement of Glycosylated Hemoglobin in Patients with Type 2 Diabetes Mellitus under Insulin Treatment by Reimbursement for Self-Monitoring of Blood Glucose
Young Shin Song, Bo Kyung Koo, Sang Wan Kim, Ka Hee Yi, Kichul Shin, Min Kyong Moon
Diabetes Metab J. 2018;42(1):28-42.   Published online September 28, 2017
DOI: https://doi.org/10.4093/dmj.2018.42.1.28
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AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy.

Methods

Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up <7%.

Results

HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P<0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P<0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022).

Conclusion

The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.

Citations

Citations to this article as recorded by  
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Clinical Care/Education
Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes
Hun-Sung Kim, Hyunah Kim, Hae-Kyung Yang, Eun Young Lee, Yoo Jin Jeong, Tong Min Kim, So Jung Yang, Seo Yeon Baik, Seung-Hwan Lee, Jae Hyoung Cho, In Young Choi, Hyeon Woo Yim, Bong-Yun Cha
Diabetes Metab J. 2017;41(3):187-194.   Published online May 12, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.3.187
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Background

When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels.

Methods

The study was conducted between January 2009 and December 2013 and included patients with DM. The glycosylated hemoglobin (HbA1c) levels were evaluated at the first visit and after 3 months. During the first medical examination, a designated doctor also conducted a diabetes education session that mainly covered dietary management.

Results

Patients were divided into those who received no diabetic medications (n=66) and those who received an OHA (n=124). Education resulted in a marked decrease in HbA1c levels in the OHA group among patients who had DM for <1 year (from 7.0%±1.3% to 6.6%±0.9%, P=0.0092) and for 1 to 5 years (from 7.5%±1.8% to 6.9%±1.1%, P=0.0091). Those with DM >10 years showed a slightly lower HbA1c target achievement rate of <6.5% (odds ratio, 0.089; P=0.0024).

Conclusion

For patients who had DM for more than 5 years, higher doses or changes in medication were more effective than intensive active education. Therefore, individualized and customized education are needed for these patients. For patients with a shorter duration of DM, it may be more effective to provide initial intensive education for diabetes before prescribing medicines, such as OHAs.

Citations

Citations to this article as recorded by  
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Review
Clinical Care/Education
A Clinical Practice Guideline to Guide a System Approach to Diabetes Care in Hong Kong
Ip Tim Lau
Diabetes Metab J. 2017;41(2):81-88.   Published online April 14, 2017
DOI: https://doi.org/10.4093/dmj.2017.41.2.81
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The Hospital Authority of Hong Kong is a statutory body that manages all the public medical care institutions in Hong Kong. There are currently around 400,000 diabetic patients under its care at 17 hospitals (providing secondary care for 40%) and 73 General Outpatient Clinics (providing primary care for 60%). The patient population has been growing at 6% to 8% per year over the past 5 years, estimated to include over 95% of all diagnosed patients in Hong Kong. In order to provide equitable and a minimal level of care within resources and local system factors constraints, a Clinical Practice Guideline on the management of type 2 diabetes mellitus was drawn in 2013 to guide a system approach to providing diabetes care. There is an algorithm for the use of various hypoglycemic agents. An organizational drug formulary governs that less expansive options have to be used first. A number of clinical care and patient empowerment programs have been set up to support structured and systematic diabetes care. With such a system approach, there have been overall improvements in diabetes care with the percentage of patients with glycosylated hemoglobin <7% rising from 40% in 2010 to 52% in 2015.

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Original Article
Clinical Care/Education
Feasibility of a Patient-Centered, Smartphone-Based, Diabetes Care System: A Pilot Study
Eun Ky Kim, Soo Heon Kwak, Seungsu Baek, Seung Lyeol Lee, Hak Chul Jang, Kyong Soo Park, Young Min Cho
Diabetes Metab J. 2016;40(3):192-201.   Published online April 8, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.3.192
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AbstractAbstract PDFPubReader   ePub   
Background

We developed a patient-centered, smartphone-based, diabetes care system (PSDCS). This study aims to test the feasibility of glycosylated hemoglobin (HbA1c) reduction with the PSDCS.

Methods

This study was a single-arm pilot study. The participants with type 2 diabetes mellitus were instructed to use the PSDCS, which integrates a Bluetooth-connected glucometer, digital food diary, and wearable physical activity monitoring device. The primary end point was the change in HbA1c from baseline after a 12-week intervention.

Results

Twenty-nine patients aged 53.9±9.1 years completed the study. HbA1c and fasting plasma glucose levels decreased significantly from baseline (7.7%±0.7% to 7.1%±0.6%, P<0.0001; 140.9±39.1 to 120.1±31.0 mg/dL, P=0.0088, respectively). The frequency of glucose monitoring correlated with the magnitude of HbA1c reduction (r=–0.57, P=0.0013). The components of the diabetes self-care activities, including diet, exercise, and glucose monitoring, were significantly improved, particularly in the upper tertile of HbA1c reduction. There were no severe adverse events during the intervention.

Conclusion

A 12-week application of the PSDCS to patients with inadequately controlled type 2 diabetes resulted in a significant HbA1c reduction with tolerable safety profiles; these findings require confirmation in a future randomized controlled trial.

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Brief Report
Epidemiology
Data Analytic Process of a Nationwide Population-Based Study Using National Health Information Database Established by National Health Insurance Service
Yong-ho Lee, Kyungdo Han, Seung-Hyun Ko, Kyung Soo Ko, Ki-Up Lee
Diabetes Metab J. 2016;40(1):79-82.   Published online February 19, 2016
DOI: https://doi.org/10.4093/dmj.2016.40.1.79
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AbstractAbstract PDFPubReader   ePub   

In 2014, the National Health Insurance Service (NHIS) signed a memorandum of understanding with the Korean Diabetes Association to provide limited open access to its databases for investigating the past and current status of diabetes and its management. NHIS databases include the entire Korean population; therefore, it can be used as a population-based nationwide study for various diseases, including diabetes and its complications. This report presents how we established the analytic system of nation-wide population-based studies using the NHIS database as follows: the selection of database study population and its distribution and operational definition of diabetes and patients of currently ongoing collaboration projects.

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    Hong Seok Lee, Jimin Clara Park, Inkwan Chung, Junxiu Liu, Seong-Su Lee, Kyungdo Han
    Diabetes Care.2023; 46(1): 92.     CrossRef
  • Association Between Glycemic Status and the Risk of Kidney Cancer in Men and Women: A Nationwide Cohort Study
    Joo-Hyun Park, Jung Yong Hong, Kyungdo Han, Jay J. Shen
    Diabetes Care.2023; 46(1): 38.     CrossRef
  • Increased end-stage renal disease risk in age-related macular degeneration: a nationwide cohort study with 10-year follow-up
    Wonyoung Jung, Junhee Park, Hye Ryoun Jang, Junseok Jeon, Kyungdo Han, Bongseong Kim, Je Moon Yoon, Dong Hui Lim, Dong Wook Shin
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  • Long‐term mortality and cardiovascular events of seven angiotensin receptor blockers in hypertensive patients: Analysis of a national real‐world database: A retrospective cohort study
    Wonjae Lee, Jeehoon Kang, Jun‐Bean Park, Won‐Woo Seo, Seung‐Yeon Lee, Woo‐Hyun Lim, Ki‐Hyun Jeon, In‐Chang Hwang, Hack‐Lyoung Kim
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  • Risk of Dementia in Newly Diagnosed Glaucoma
    Do Young Park, Mina Kim, Yoonjong Bae, Hyemin Jang, Dong Hui Lim
    Ophthalmology.2023; 130(7): 684.     CrossRef
  • Associations of reproductive factors with incidence of myocardial infarction and ischemic stroke in postmenopausal women: a cohort study
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  • Association of general and central obesity, and their changes with risk of knee osteoarthritis: a nationwide population-based cohort study
    Dojoon Park, Yong-Moon Park, Seung-Hyun Ko, Kang-Se Hyun, Youn-Ho Choi, Dong-Uk Min, Kyungdo Han, Hae-Seok Koh
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  • Comparison of Operational Definition of Type 2 Diabetes Mellitus Based on Data from Korean National Health Insurance Service and Korea National Health and Nutrition Examination Survey
    Jong Ha Baek, Yong-Moon Park, Kyung Do Han, Min Kyong Moon, Jong Han Choi, Seung-Hyun Ko
    Diabetes & Metabolism Journal.2023; 47(2): 201.     CrossRef
  • A population-based cohort study on risk factors for acute pancreatitis: A comparison by age group
    Jin Myung Park, Namyoung Park, Sang Hyub Lee, Kyung Do Han, Chang Don Kang, Jae Min Lee, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim
    Pancreatology.2023; 23(3): 321.     CrossRef
  • Blood pressure and dementia risk by physical frailty in the elderly: a nationwide cohort study
    Mi Hee Cho, Kyungdo Han, Seungwoo Lee, Su-Min Jeong, Jung Eun Yoo, SangYun Kim, Jinkook Lee, Sohyun Chun, Dong Wook Shin
    Alzheimer's Research & Therapy.2023;[Epub]     CrossRef
  • Cumulative exposure to metabolic syndrome in a national population-based cohort of young adults and sex-specific risk for type 2 diabetes
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  • Age‐Related Macular Degeneration With Visual Disability Is Associated With Cardiovascular Disease Risk in the Korean Nationwide Cohort
    Wonyoung Jung, Kyungdo Han, Bongseong Kim, Sungsoon Hwang, Je Moon Yoon, Junhee Park, Dong Hui Lim, Dong Wook Shin
    Journal of the American Heart Association.2023;[Epub]     CrossRef
  • Association of Metabolic Syndrome Components and Nutritional Status with Kidney Cancer in Young Adult Population: A Nationwide Population-Based Cohort Study in Korea
    Hee Yeon Lee, Kyung-Do Han, In Sook Woo, Hyuk-Sang Kwon
    Biomedicines.2023; 11(5): 1425.     CrossRef
  • Nationwide trends in the prevalence and incidence of depressive disorders and their correlates among adults with disabilities in Korea from 2006 to 2017
    Hwa-Young Lee, So Young Kim, Kyoung Eun Yeob, Yeon Yong Kim, Jong-Hyock Park
    International Journal of Social Psychiatry.2023; 69(7): 1670.     CrossRef
  • Association between glycemic status and the risk of acute pancreatitis: a nationwide population-based study
    In Rae Cho, Kyung-Do Han, Sang Hyub Lee, Young Hoon Choi, Kwang Hyun Chung, Jin Ho Choi, Namyoung Park, Min Woo Lee, Woo Hyun Paik, Ji Kon Ryu, Yong-Tae Kim
    Diabetology & Metabolic Syndrome.2023;[Epub]     CrossRef
  • Association between fatty liver index and risk of end-stage renal disease stratified by kidney function in patients with type 2 diabetes: A nationwide population-based study
    Goh Eun Chung, Kyungdo Han, Kyu-Na Lee, Jung Ho Bae, Sun Young Yang, Su-Yeon Choi, Jeong Yoon Yim, Nam Ju Heo
    Diabetes & Metabolism.2023; 49(4): 101454.     CrossRef
  • Incidence and adverse clinical events of primary sclerosing cholangitis with ulcerative colitis
    In Sub Han, Dong Hoon Baek, Seung Min Hong, Bong Eun Lee, Moon Won Lee, Gwang Ha Kim, Geun Am Song
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • Risk of developing chronic kidney disease in young-onset Type 2 diabetes in Korea
    Joonyub Lee, Seung-Hwan Lee, Kun-Ho Yoon, Jae Hyoung Cho, Kyungdo Han, Yeoree Yang
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  • A cohort study found a high risk of end-stage kidney disease associated with acromegaly
    Sangmo Hong, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
    Kidney International.2023; 104(4): 820.     CrossRef
  • Higher metabolic variability increases the risk of depressive disorder in type 2 diabetes mellitus: a longitudinal nationwide cohort study
    Ji Hyun An, Kyung-do Han, Hong Jin Jeon
    Frontiers in Psychiatry.2023;[Epub]     CrossRef
  • Association of Sustained Low or High Income and Income Changes With Risk of Incident Type 2 Diabetes Among Individuals Aged 30 to 64 Years
    Jimin Clara Park, Ga Eun Nam, Jinna Yu, Ketrell L. McWhorter, Junxiu Liu, Hong Seok Lee, Seong-Su Lee, Kyungdo Han
    JAMA Network Open.2023; 6(8): e2330024.     CrossRef
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    Chan Hyuk Park, Sun-Young Jung, Ju Won Lee, Hyo-Joon Yang, Joon Sung Kim, Beom Jin Kim, Soo In Choi, Seung In Seo, Joongyub Lee, Jae Gyu Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Kyuho Kim, Bongseong Kim, Hyunho Kim, Hyung Soon Park, Yu-Bae Ahn, Seung-Hyun Ko, Kyungdo Han, Jae-Seung Yun
    Diabetes Research and Clinical Practice.2023; 203: 110866.     CrossRef
  • Impact of Concomitant Use of Proton Pump Inhibitors and Clopidogrel on Recurrent Stroke and Myocardial Infarction
    Yong Kang Lee, Hyun Sun Lim, Youn I Choi, Eun Ju Choe, Seonji Kim, Seng Chan You, Kyung Joo Lee, Yerim Kim, Da Hee Park, Woon Geon Shin, Seung In Seo
    Pharmaceuticals.2023; 16(9): 1213.     CrossRef
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    Hwa Young Ahn, Sun Wook Cho, Mi Young Lee, Young Joo Park, Bon Seok Koo, Hang-Seok Chang, Ka Hee Yi
    Endocrinology and Metabolism.2023; 38(4): 436.     CrossRef
  • Low Household Income Status and Death from Pneumonia in People with Type 2 Diabetes Mellitus: A Nationwide Study
    You-Bin Lee, So Hee Park, Kyu-na Lee, Bongsung Kim, So Yoon Kwon, Jiyun Park, Gyuri Kim, Sang-Man Jin, Kyu Yeon Hur, Kyungdo Han, Jae Hyeon Kim
    Diabetes & Metabolism Journal.2023; 47(5): 682.     CrossRef
  • Risk of depression in patients with acromegaly in Korea (2006-2016): a nationwide population-based study
    Shinje Moon, Sangmo Hong, Kyungdo Han, Cheol-Young Park
    European Journal of Endocrinology.2023; 189(3): 363.     CrossRef
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    Inho Song, Hyeryeong Nam, Bora Lee, Byung Kwan Park, Jeong-ki Kim, Seung-Bum Ryoo, Kyu Joo Park, Eon Chul Han
    Annals of Surgical Treatment and Research.2023; 105(5): 281.     CrossRef
  • Association between Smoking Cessation and the Risk of Cholangiocarcinoma and Ampulla of Vater Cancer: A Nationwide Cohort Study
    Joo-Hyun Park, Jung Yong Hong, Kyungdo Han
    Liver Cancer.2023; 12(5): 457.     CrossRef
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    Se Young Jung, Sohyun Chun, Eun Bin Cho, Kyungdo Han, Juhwan Yoo, Yohwan Yeo, Jung Eun Yoo, Su Min Jeong, Ju-Hong Min, Dong Wook Shin
    Frontiers in Aging Neuroscience.2023;[Epub]     CrossRef
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    Jung Eun Yoo, Youn Huh, Sang-Hyun Park, Kyungdo Han, Hye Soon Park, Kyung Hwan Cho, Jin-Soo Ahn, Sang Ho Jun, Ga Eun Nam
    Journal of the American Medical Directors Association.2023; 24(12): 1924.     CrossRef
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    Chaeyeon Lee, Eunhae Shin, Mina Kim, Yoonjong Bae, Tae-Young Chung, Sang Won Seo, Hyemin Jang, Dong Hui Lim
    Journal of Clinical Medicine.2023; 12(20): 6441.     CrossRef
  • The Impact of Neighborhood Deprivation on the Survival Rates of Patients with Cancer in Korea
    Wonyoung Jung, Dong Wook Shin, Kyu-Won Jung, Dongjin Kim, Juwon Park, Fatima Nari, Mina Suh
    Healthcare.2023; 11(24): 3171.     CrossRef
  • Declined incidence of patients treated for vision-threatening diabetic retinopathy in South Korea: a 12-year nationwide population-based study
    Jiwon Kim, Hyojin Seong, Kang Ju Son, Eun Jee Chung
    Graefe's Archive for Clinical and Experimental Ophthalmology.2022; 260(1): 101.     CrossRef
  • Female reproductive factors and risk of joint replacement arthroplasty of the knee and hip due to osteoarthritis in postmenopausal women: a nationwide cohort study of 1.13 million women
    Y. Eun, J.E. Yoo, K. Han, D. Kim, K.N. Lee, J. Lee, D.-Y. Lee, D.-H. Lee, H. Kim, D.W. Shin
    Osteoarthritis and Cartilage.2022; 30(1): 69.     CrossRef
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    Chan Joo Lee, Ji-Yeon Lee, Kyungdo Han, Da Hye Kim, Hanna Cho, Kwang Joon Kim, Eun Seok Kang, Bong-Soo Cha, Yong-ho Lee, Sungha Park
    Hypertension.2022; 79(1): 218.     CrossRef
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    Joo-Hyun Park, Kyungdo Han, Jung Yong Hong, Young Suk Park, Kyu Yeon Hur, Gunseog Kang, Joon Oh Park
    Gastroenterology.2022; 162(2): 509.     CrossRef
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    Sangmo Hong, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
    European Heart Journal.2022; 43(15): 1491.     CrossRef
  • Blood Pressure Variability and the Risk of Fracture: A Nationwide Cohort Study
    Jung Eun Yoo, Ji Won Yoon, Hyo Eun Park, Kyungdo Han, Dong Wook Shin
    The Journal of Clinical Endocrinology & Metabolism.2022; 107(4): e1488.     CrossRef
  • Cost-effectiveness analysis of intensive blood pressure control in Korea
    Ye Seol Lee, Hae-Young Lee, Tae Hyun Kim
    Hypertension Research.2022; 45(3): 507.     CrossRef
  • Associations of variability in body weight and glucose levels with the risk of hip fracture in people with diabetes
    Jeongmin Lee, Kyungdo Han, Sang Hyun Park, Mee Kyoung Kim, Dong-Jun Lim, Kun-Ho Yoon, Moo-Il Kang, Seung-Hwan Lee
    Metabolism.2022; 129: 155135.     CrossRef
  • Severe Hypoglycemia Increases Dementia Risk and Related Mortality: A Nationwide, Population-based Cohort Study
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    The Journal of Clinical Endocrinology & Metabolism.2022; 107(5): e1976.     CrossRef
  • Association between alcohol consumption and pancreatic cancer risk differs by glycaemic status: A nationwide cohort study
    Joo-Hyun Park, Kyungdo Han, Jung Yong Hong, Young Suk Park, Joon Oh Park
    European Journal of Cancer.2022; 163: 119.     CrossRef
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    Hyung-jin Cho, Ju-hwan Yoo, Mi-hyeong Kim, Kyung-jai Ko, Kang-woong Jun, Kyung-do Han, Jeong-kye Hwang
    Scientific Reports.2022;[Epub]     CrossRef
  • Female Reproductive Factors and the Risk of Bronchiectasis: A Nationwide Population-Based Longitudinal Study
    Bumhee Yang, Dong-Hwa Lee, Kyungdo Han, Hayoung Choi, Hyung Koo Kang, Dong Wook Shin, Hyun Lee
    Biomedicines.2022; 10(2): 303.     CrossRef
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    Journal of Neurotrauma.2022; 39(5-6): 390.     CrossRef
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    Chung-woo Lee, Joo Kyung Lee, Yeon Joo Choi, Hyunjin Kim, Kyungdo Han, Jin-hyung Jung, Do Hoon Kim, Joo-Hyun Park
    Scientific Reports.2022;[Epub]     CrossRef
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    Hye Seon Kang, Yong-Moon Park, Seung-Hyun Ko, Seung Hoon Kim, Shin Young Kim, Chi Hong Kim, Kyungdo Han, Sung Kyoung Kim
    Journal of Clinical Medicine.2022; 11(4): 1077.     CrossRef
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    JAMA Network Open.2022; 5(2): e220262.     CrossRef
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    Thyroid®.2022; 32(4): 440.     CrossRef
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  • Hip Fracture Risk According to Diabetic Kidney Disease Phenotype in a Korean Population
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    Endocrinology and Metabolism.2022; 37(1): 148.     CrossRef
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    Journal of Korean Medical Science.2022;[Epub]     CrossRef
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    The Korean Journal of Internal Medicine.2022; 37(3): 639.     CrossRef
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    PLOS ONE.2022; 17(4): e0263046.     CrossRef
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    Diabetes Care.2022; 45(5): 1091.     CrossRef
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    Journal of Lipid and Atherosclerosis.2022; 11(2): 103.     CrossRef
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    Frontiers in Neurology.2022;[Epub]     CrossRef
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    Biomedicines.2022; 10(6): 1245.     CrossRef
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    Journal of Clinical Oncology.2022; 40(31): 3623.     CrossRef
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    Soon Ok Lee, Jeong Eun Lee, Shinwon Lee, Sun Hee Lee, Jin Suk Kang, Hyunjin Son, Hyungi Lee, Jinmi Kim
    Scientific Reports.2022;[Epub]     CrossRef
  • Increased risk of pancreatic cancer in individuals with non-alcoholic fatty liver disease
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  • Colonoscopy decreases mortality in colorectal cancer patients compared with fecal immunochemical test
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    Journal of Gastroenterology and Hepatology.2022; 37(10): 1991.     CrossRef
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    International Journal of Environmental Research and Public Health.2022; 19(14): 8615.     CrossRef
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    Scientific Reports.2022;[Epub]     CrossRef
  • Comparative Effects of Sodium-Glucose Cotransporter 2 Inhibitor and Thiazolidinedione Treatment on Risk of Stroke among Patients with Type 2 Diabetes Mellitus
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    Diabetes & Metabolism Journal.2022; 46(4): 567.     CrossRef
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    Diabetes & Metabolism Journal.2022; 46(4): 552.     CrossRef
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    Journal of Clinical Medicine.2022; 11(16): 4911.     CrossRef
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    Diabetes & Metabolism Journal.2022; 46(5): 722.     CrossRef
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    Diabetes Research and Clinical Practice.2022; 192: 110083.     CrossRef
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    Diabetes & Metabolism Journal.2022; 46(5): 701.     CrossRef
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    Biomedicines.2022; 10(10): 2435.     CrossRef
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    International Journal of Environmental Research and Public Health.2022; 19(20): 13672.     CrossRef
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    Medicine.2022; 101(42): e31272.     CrossRef
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    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Association between serum ferritin levels and colorectal cancer risk in Korea
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    The Korean Journal of Internal Medicine.2022; 37(6): 1205.     CrossRef
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    Cardiovascular Diabetology.2022;[Epub]     CrossRef
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    Journal of Periodontology.2021; 92(3): 371.     CrossRef
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    Journal of the European Academy of Dermatology and Venereology.2021; 35(1): 222.     CrossRef
  • The risk of hip fractures in individuals over 50 years old with prediabetes and type 2 diabetes – A longitudinal nationwide population-based study
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    Bone.2021; 142: 115691.     CrossRef
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    JAMA Network Open.2021; 4(1): e2030405.     CrossRef
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    Diabetes & Metabolism Journal.2021; 45(1): 115.     CrossRef
  • High-Density Lipoprotein Cholesterol and the Risk of Myocardial Infarction, Stroke, and Cause-Specific Mortality: a Nationwide Cohort Study in Korea
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    Journal of Lipid and Atherosclerosis.2021; 10(1): 74.     CrossRef
  • Estimated Incidence and Projections of Treatment Cost for Vision-threatening Diabetic Retinopathy in Korea
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  • Risk of gastrointestinal cancer in patients with an elevated level of gamma-glutamyltransferase: A nationwide population-based study
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Original Articles
Economic Impact of Combining Metformin with Dipeptidyl Peptidase-4 Inhibitors in Diabetic Patients with Renal Impairment in Spanish Patients
Antoni Sicras-Mainar, Ruth Navarro-Artieda
Diabetes Metab J. 2015;39(1):74-81.   Published online February 16, 2015
DOI: https://doi.org/10.4093/dmj.2015.39.1.74
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AbstractAbstract PDFPubReader   ePub   
Background

To evaluate resource use and health costs due to the combination of metformin and dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with diabetes and renal impairment in routine clinical practice.

Methods

An observational, retrospective study was performed. Patients aged ≥30 years treated with metformin who initiated a second oral antidiabetic treatment in 2009 to 2010 were included. Two groups of patients were analysed: metformin+DPP-4 inhibitors and other oral antidiabetics. The main measures were: compliance, persistence, metabolic control (glycosylated hemoglobin< 7%) and complications (hypoglycemia, cardiovascular events) and total costs. Patients were followed up for 2 years.

Results

We included 395 patients, mean age 70.2 years, 56.5% male: 135 patients received metformin+DPP-4 inhibitors and 260 patients received metformin+other oral antidiabetics. Patients receiving DPP-4 inhibitors showed better compliance (66.0% vs. 60.1%), persistence (57.6% vs. 50.0%), and metabolic control (63.9% vs. 57.3%), respectively, compared with those receiving other oral antidiabetics (P<0.05), and also had a lower rate of hypoglycemia (20.0% vs. 47.7%) and lower total costs (€ 2,486 vs. € 3,002), P=0.001.

Conclusion

Despite the limitations of the study, patients with renal impairment treated with DPP-4 inhibitors had better metabolic control, lower rates (association) of hypoglycaemia, and lower health costs for the Spanish national health system.

Citations

Citations to this article as recorded by  
  • Comparative Efficacy, Safety, and Cost‐Utility of DPP‐4 Inhibitors and Metformin Combination Therapy in Type 2 Diabetes: A Systematic Review of Real‐World Clinical and Economic Outcomes
    Abdulgafar Olayiwola Jimoh, Shuaibu Abdullahi Hudu, Anas Ahmad Sabir, Adamu Ahmed Adamu, Nura Bello, Albashir Tahir, Nura Abubakar, Huantian Cui
    Journal of Diabetes Research.2026;[Epub]     CrossRef
  • Characteristics of Hypoglycemia Pateints Visiting the Emergency Department of a University Hospital
    Sang-Hyeon Choi, Deok-Ki Youn, Moon-Gi Choi, Ohk-Hyun Ryu
    The Journal of Korean Diabetes.2016; 17(3): 202.     CrossRef
  • Response: Economic Impact of Combining Metformin with Dipeptidyl Peptidase-4 Inhibitors in Diabetic Patients with Renal Impairment in Spanish Patients (Diabetes Metab J2015;39:74-81)
    Antoni Sicras-Mainar, Ruth Navarro-Artieda
    Diabetes & Metabolism Journal.2015; 39(2): 173.     CrossRef
  • Dipeptidyl Peptidase 4: A New Link between Diabetes Mellitus and Atherosclerosis?
    Wellington Santana da Silva Júnior, Amélio Fernando de Godoy-Matos, Luiz Guilherme Kraemer-Aguiar
    BioMed Research International.2015; 2015: 1.     CrossRef
  • Letter: Economic Impact of Combining Metformin with Dipeptidyl Peptidase-4 Inhibitors in Diabetic Patients with Renal Impairment in Spanish Patients (Diabetes Metab J2015;39:74-81)
    Hannah Seok
    Diabetes & Metabolism Journal.2015; 39(2): 171.     CrossRef
Background and Data Configuration Process of a Nationwide Population-Based Study Using the Korean National Health Insurance System
Sun Ok Song, Chang Hee Jung, Young Duk Song, Cheol-Young Park, Hyuk-Sang Kwon, Bong Soo Cha, Joong-Yeol Park, Ki-Up Lee, Kyung Soo Ko, Byung-Wan Lee
Diabetes Metab J. 2014;38(5):395-403.   Published online October 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.5.395
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AbstractAbstract PDFPubReader   ePub   
Background

The National Health Insurance Service (NHIS) recently signed an agreement to provide limited open access to the databases within the Korean Diabetes Association for the benefit of Korean subjects with diabetes. Here, we present the history, structure, contents, and way to use data procurement in the Korean National Health Insurance (NHI) system for the benefit of Korean researchers.

Methods

The NHIS in Korea is a single-payer program and is mandatory for all residents in Korea. The three main healthcare programs of the NHI, Medical Aid, and long-term care insurance (LTCI) provide 100% coverage for the Korean population. The NHIS in Korea has adopted a fee-for-service system to pay health providers. Researchers can obtain health information from the four databases of the insured that contain data on health insurance claims, health check-ups and LTCI.

Results

Metabolic disease as chronic disease is increasing with aging society. NHIS data is based on mandatory, serial population data, so, this might show the time course of disease and predict some disease progress, and also be used in primary and secondary prevention of disease after data mining.

Conclusion

The NHIS database represents the entire Korean population and can be used as a population-based database. The integrated information technology of the NHIS database makes it a world-leading population-based epidemiology and disease research platform.

Citations

Citations to this article as recorded by  
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    Annals of Hepatology.2026; 31(1): 102175.     CrossRef
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    American Journal of Gastroenterology.2025; 120(2): 410.     CrossRef
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    Leerang Lim, Eun Jin Jang, Jun Woo Jo, Junghoon Shin, Hyobin Lee, Hannah Lee, Seung-Young Oh, Hyunjae Im, Ho Geol Ryu
    Transplantation Proceedings.2023; 55(7): 1715.     CrossRef
  • Association between periodontal disease status and risk of atrial fibrillation: a nationwide population-based cohort study
    Jung-Hyun Park, Hyungwoo Lee, Jin-Woo Kim, Tae-Jin Song
    BMC Oral Health.2023;[Epub]     CrossRef
  • Trends in the incidence and prevalence of dysphagia requiring medical attention among adults in South Korea, 2006–2016: A nationwide population study
    SuYeon Kwon, Seungwoo Cha, Junsik Kim, Kyungdo Han, Nam-Jong Paik, Won-Seok Kim, Sina Azadnajafabad
    PLOS ONE.2023; 18(6): e0287512.     CrossRef
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    Byungyoon Yun, Juyeon Oh, Jaesung Choi, Laura S. Rozek, Heejoo Park, Juho Sim, Yangwook Kim, Jongmin Lee, Jin-Ha Yoon
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Association between smoking status and death from COVID-19 in South Korea: A nationwide cohort study
    Jae Woo Choi
    Tobacco Induced Diseases.2023; 21(July): 1.     CrossRef
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    Sangmo Hong, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
    Kidney International.2023; 104(4): 820.     CrossRef
  • Comparative cardiovascular outcomes in type 2 diabetes patients taking dapagliflozin versus empagliflozin: a nationwide population-based cohort study
    Jaehyun Lim, You-Jung Choi, Bong Sung Kim, Tae-Min Rhee, Hyun-Jung Lee, Kyung-Do Han, Jun-Bean Park, Jin Oh Na, Yong-Jin Kim, Heesun Lee, Hyung-Kwan Kim
    Cardiovascular Diabetology.2023;[Epub]     CrossRef
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    Donghee Kwak, Seok-joo Moon, Jong Woong Park, Duk Hee Lee, Jung Il Lee
    Orthopaedic Journal of Sports Medicine.2023;[Epub]     CrossRef
  • Incident dementia in kidney transplantation recipients: a matched comparative nationwide cohort study in South Korea
    Seon Ha Baek, Jina Park, Sehoon Park, Mi-yeon Yu, Ji Eun Kim, Sang Hyun Park, Kyungdo Han, Yong Chul Kim, Dong Ki Kim, Kwon Wook Joo, Yon Su Kim, Hajeong Lee
    Kidney Research and Clinical Practice.2023; 42(4): 519.     CrossRef
  • Developing Operational Definitions Related toHelicobacter pyloriEradication Therapy
    Chan Hyuk Park, Sun-Young Jung, Ju Won Lee, Hyo-Joon Yang, Joon Sung Kim, Beom Jin Kim, Soo In Choi, Seung In Seo, Joongyub Lee, Jae Gyu Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Ji Min Lee, Kyungdo Han, Kang-Moon Lee, Jae-Seung Yun
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Sex differences in mortality in patients with acromegaly: a nationwide cohort study in Korea
    Jiwon Kim, Namki Hong, Jimi Choi, Ju Hyung Moon, Eui Hyun Kim, Jae Won Hong, Eun Jig Lee, Sin Gon Kim, Cheol Ryong Ku
    European Journal of Endocrinology.2023; 189(2): 225.     CrossRef
  • Proton pump inhibitor use and the risk of metachronous gastric cancer after H. pylori eradication in patients who underwent endoscopic resection for gastric neoplasms: A population‐based cohort study
    Eun Jeong Gong, Hye‐Kyung Jung, Bora Lee, Jitaek Hong, Jong Wook Kim, Cheol Min Shin, Young Hoon Youn, Kwang Jae Lee
    Alimentary Pharmacology & Therapeutics.2023; 58(7): 668.     CrossRef
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    Hyun Jee Lee, Yujin Choi, Jaeyu Park, Yong-Sung Choi, Dong Keon Yon, Do Hyun Kim
    Children.2023; 10(9): 1436.     CrossRef
  • Impact of Concomitant Use of Proton Pump Inhibitors and Clopidogrel on Recurrent Stroke and Myocardial Infarction
    Yong Kang Lee, Hyun Sun Lim, Youn I Choi, Eun Ju Choe, Seonji Kim, Seng Chan You, Kyung Joo Lee, Yerim Kim, Da Hee Park, Woon Geon Shin, Seung In Seo
    Pharmaceuticals.2023; 16(9): 1213.     CrossRef
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    Jae Young Kim, Changhwan Seo, Haeyong Pak, Hyunsun Lim, Tae Ik Chang
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Occupational characteristics and risk factors associated with endometriosis among Korean female workers
    Seunghyun Lee, Seung-Yeon Lee, Wanhyung Lee, Federico Romano
    PLOS ONE.2023; 18(10): e0292362.     CrossRef
  • Suicidal Thinking Among Patients With Spinal Conditions in South Korea: A Population-Based Cross-Sectional Study
    Tak Kyu Oh, Hye Yoon Park, In-Ae Song
    Psychiatry Investigation.2023; 20(9): 834.     CrossRef
  • Increased risk of venous and arterial thromboembolism in patients with colorectal cancer receiving cetuximab-based combination chemotherapy: A population-based study in Korea
    Ho-Young Yhim, Juhyun Lee, Kyoung Ha Kim, Sang-A Kim, Ji Yun Lee, Hun-Gyu Hwang, Junshik Hong, Jeong-Ok Lee, Soo-Mee Bang
    Thrombosis Research.2023; 231: 50.     CrossRef
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    Ga Hee Kim, Hyungchul Park, Kee Wook Jung, Min-Ju Kim, Ye-Jee Kim, Ji Min Lee, Bong Eun Lee, Yang Won Min, Jeong Hwan Kim, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Hyun Jin Kim
    Gut and Liver.2023; 17(6): 894.     CrossRef
  • Differential Impact of Obesity on the Risk of Diabetes Development in Two Age Groups: Analysis from the National Health Screening Program
    Tae Kyung Yoo, Kyung-Do Han, Yang-Hyun Kim, Ga Eun Nam, Sang Hyun Park, Eun-Jung Rhee, Won-Young Lee
    Diabetes & Metabolism Journal.2023; 47(6): 846.     CrossRef
  • Association between preoperative modifiable lifestyle factors and mortality after cancer surgery: a population-based cohort study in South Korea
    Tak Kyu Oh, In-Ae Song
    Annals of Surgical Treatment and Research.2023; 105(4): 179.     CrossRef
  • Classification of long-term clinical course of Parkinson’s disease using clustering algorithms on social support registry database
    Dougho Park, Su Yun Lee, Jong Hun Kim, Hyoung Seop Kim
    Journal of Big Data.2023;[Epub]     CrossRef
  • Association between Proteinuria Status and Risk of Hypertension: A Nationwide Population-Based Cohort Study
    Hyungwoo Lee, Moo-Suk Park, Min Kyoung Kang, Tae-Jin Song
    Journal of Personalized Medicine.2023; 13(9): 1414.     CrossRef
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    Ji hyun An, Kyung-do Han, Jin-Hyung Jung, Hong Jin Jeon
    Journal of Psychiatric Research.2023; 167: 93.     CrossRef
  • Effect of changes in the hearing aid subsidy on the prevalence of hearing loss in South Korea
    Chul Young Yoon, Junhun Lee, Tae Hoon Kong, Young Joon Seo
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  • Preoperative Body Mass Index, Waist Circumference, and Mortality After Major Cancer Surgery: A Nationwide Cohort Study in Korea
    Tak Kyu Oh, In-Ae Song
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
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    Hye Hyeon Kim, Jin Hyuk Lee, In Han Song, Yu Rang Park
    Psychiatry Research.2023; 330: 115613.     CrossRef
  • Association Between Premature Menopause and Cardiovascular Diseases and All‐Cause Mortality in Korean Women
    Gyu Bae Lee, Ga Eun Nam, Wonsock Kim, Byoungduck Han, Kyung Hwan Cho, Seon Mee Kim, Youn Seon Choi, Do Hoon Kim, Yong‐Gyu Park, Jin‐Hyung Jung, Kyungdo Han, Yang‐Hyun Kim
    Journal of the American Heart Association.2023;[Epub]     CrossRef
  • Risk of gastric cancer among long-term proton pump inhibitor users: a population-based cohort study
    Jong Wook Kim, Hye-Kyung Jung, Bora Lee, Cheol Min Shin, Eun Jeong Gong, Jitaek Hong, Young Hoon Youn, Kwang Jae Lee
    European Journal of Clinical Pharmacology.2023; 79(12): 1699.     CrossRef
  • Cancer Risk in Elderly Korean Patients with Neurodegenerative Disease and its relation to Type 2 Diabetes
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    The Open Neurology Journal.2023;[Epub]     CrossRef
  • Performance of Cardiovascular Risk Prediction Models in Korean Patients With New‐Onset Rheumatoid Arthritis: National Cohort Study
    Jae Hyun Kim, Gaeun Lee, Jinseub Hwang, Ji‐Won Kim, Jin‐Won Kwon, Yun‐Kyoung Song
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    Annals of Surgery.2023; 278(6): 1024.     CrossRef
  • Decreased Risk of Knee Osteoarthritis with Taller Height in an East Asian Population: A Nationwide Cohort Study
    Dong Hwan Lee, Hwa Sung Lee, Soo Hyun Jang, Jun-Young Heu, Kyungdo Han, Se-Won Lee
    Journal of Clinical Medicine.2023; 13(1): 92.     CrossRef
  • Cost-effectiveness of the anti-vascular endothelial growth factor intravitreal injection and panretinal photocoagulation for patients with proliferative diabetic retinopathy in South Korea
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  • Prior Evaluation of Nutritional Status and Mortality in Patients with Sepsis in South Korea
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    Nutrients.2023; 15(24): 5040.     CrossRef
  • Increased Risk of Hip Fracture in Patients with Acromegaly: A Nationwide Cohort Study in Korea
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    Endocrinology and Metabolism.2023; 38(6): 690.     CrossRef
  • Proton Pump Inhibitor Co-Therapy in Patients with Atrial Fibrillation Treated with Oral Anticoagulants and a Prior History of Upper Gastrointestinal Tract Bleeding
    So-Ryoung Lee, Soonil Kwon, Eue-Keun Choi, Jin-Hyung Jung, Kyung-Do Han, Seil Oh, Gregory Y. H. Lip
    Cardiovascular Drugs and Therapy.2022; 36(4): 679.     CrossRef
  • Institutional case volume-incorporated mortality risk prediction model for cardiac surgery
    Seohee Lee, Eun Jin Jang, Junwoo Jo, Dongnyeok Park, Ho Geol Ryu
    Asian Journal of Surgery.2022; 45(1): 189.     CrossRef
  • Does Surgical Ablation of Atrial Fibrillation Benefit Patients Undergoing Bioprosthetic Valve Replacement?
    Won Kyung Pyo, Ho Jin Kim, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
    Seminars in Thoracic and Cardiovascular Surgery.2022; 34(3): 906.     CrossRef
  • Burden of comorbidities and medication use in childbearing women with rheumatic diseases: a nationwide population-based study
    Min Kyung Chung, Chan Hee Lee, Jin Su Park, Hyunsun Lim, Jisoo Lee
    The Korean Journal of Internal Medicine.2022; 37(6): 1250.     CrossRef
  • Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality
    In‐Ae Song, Eun Sun Jang, Tak Kyu Oh
    Hepatology Communications.2022; 6(4): 740.     CrossRef
  • Blood Pressure Levels and Risks of Dementia: a Nationwide Study of 4.5 Million People
    Chan Joo Lee, Ji-Yeon Lee, Kyungdo Han, Da Hye Kim, Hanna Cho, Kwang Joon Kim, Eun Seok Kang, Bong-Soo Cha, Yong-ho Lee, Sungha Park
    Hypertension.2022; 79(1): 218.     CrossRef
  • Continuing regular physical activity and maintaining body weight have a synergistic interaction in improving survival: a population-based cohort study including 6.5 million people
    Chang-Hoon Lee, Kyung-Do Han, Da Hye Kim, Min-Sun Kwak
    European Journal of Preventive Cardiology.2022; 29(3): 547.     CrossRef
  • Liver enzymes and risk of ocular motor cranial nerve palsy: a nationwide population-based study
    Joonhyoung Kim, Kyungdo Han, Juhwan Yoo, Kyung-Ah Park, Sei Yeul Oh
    Neurological Sciences.2022; 43(5): 3395.     CrossRef
  • Underutilisation of prophylactic G-CSF in breast cancer patients receiving adjuvant docetaxel/cyclophosphamide chemotherapy
    Minhee Ku, Nam Kyung Je
    Journal of Chemotherapy.2022; 34(8): 534.     CrossRef
  • Epidemiologic study of bladder and urethral injury in Korea: A nationwide population-based study
    Bum Sik Tae, Young Eun Yoon, Woong Na, Kyung Jin Oh, Sung Yul Park, Jae Young Park, Hong Sang Moon
    Investigative and Clinical Urology.2022; 63(1): 92.     CrossRef
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    Sangmo Hong, Kyung-Soo Kim, Kyungdo Han, Cheol-Young Park
    European Heart Journal.2022; 43(15): 1491.     CrossRef
  • Pericardial Versus Porcine Valves for Surgical Aortic Valve Replacement
    Hong Ju Shin, Wan Kee Kim, Jin Kyoung Kim, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee
    Korean Circulation Journal.2022; 52(2): 136.     CrossRef
  • Effect of obesity and metabolic health on urolithiasis: A nationwide population-based study
    Changil Choi, Jong Keun Kim, Kyungdo Han, Young Goo Lee, Jun Hyun Han
    Investigative and Clinical Urology.2022; 63(1): 63.     CrossRef
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  • Development of eClaim system for private indemnity health insurance in South Korea: Compatibility and interoperability
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    Health Informatics Journal.2022;[Epub]     CrossRef
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    Journal of Neurotrauma.2022; 39(5-6): 390.     CrossRef
  • Female Reproductive Factors and the Risk of Bronchiectasis: A Nationwide Population-Based Longitudinal Study
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    Biomedicines.2022; 10(2): 303.     CrossRef
  • Clinical outcomes of early closure versus conservative strategy after diagnosis with atrial septal defect: a nationwide population-based cohort study
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    Gyeongsil Lee, Seulggie Choi, Yoosun Cho, Sang Min Park
    Clinical Nutrition Research.2022; 11(1): 32.     CrossRef
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    Resuscitation.2022; 173: 31.     CrossRef
  • Blood pressure and mortality after percutaneous coronary intervention: a population-based cohort study
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    Scientific Reports.2022;[Epub]     CrossRef
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    JAMA Network Open.2022; 5(2): e220262.     CrossRef
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    Endocrinology and Metabolism.2022; 37(1): 148.     CrossRef
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    Diagnostics.2022; 12(3): 663.     CrossRef
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    Journal of Psychiatric Research.2022; 149: 226.     CrossRef
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    Scientific Reports.2022;[Epub]     CrossRef
  • Prognosis of pregnancy after breast cancer diagnosis according to the type of treatment: A population-based study in Korea by the SMARTSHIP group
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    Journal of Bone and Mineral Metabolism.2022; 40(4): 602.     CrossRef
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    Archives of Orthopaedic and Trauma Surgery.2022; 143(5): 2307.     CrossRef
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    PLOS ONE.2022; 17(4): e0266262.     CrossRef
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    Cancer Research and Treatment.2022; 54(2): 572.     CrossRef
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    International Journal of Environmental Research and Public Health.2022; 19(9): 4949.     CrossRef
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    Nutrients.2022; 14(8): 1644.     CrossRef
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    British Journal of Cancer.2022; 127(3): 549.     CrossRef
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    Journal of the American Heart Association.2022;[Epub]     CrossRef
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    Journal of Personalized Medicine.2022; 12(5): 691.     CrossRef
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    Journal of Clinical Oncology.2022; 40(29): 3394.     CrossRef
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    Journal of Lipid and Atherosclerosis.2022; 11(2): 178.     CrossRef
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    Frontiers in Neurology.2022;[Epub]     CrossRef
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    Cancers.2022; 14(11): 2604.     CrossRef
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    Hypertension.2022; 79(7): 1466.     CrossRef
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    International Journal of Cancer.2022; 151(7): 1024.     CrossRef
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    Eun Bin Cho, Yohwan Yeo, Jin-Hyung Jung, Su-Min Jeong, Kyungdo Han, Jeong Hoon Yang, Dong Wook Shin, Ju-Hong Min
    Multiple Sclerosis Journal.2022; 28(12): 1849.     CrossRef
  • Nationwide population-based incidence of cancer among patients with HIV/AIDS in South Korea
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    Scientific Reports.2022;[Epub]     CrossRef
  • Association between migraine and risk of ocular motor cranial nerve palsy
    Soolienah Rhiu, Kyungdo Han, Juhwan Yoo, Kyung-Ah Park, Sei Yeul Oh
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  • Statin use and risk of progression to liver cirrhosis in chronic hepatitis B independent of conventional risk factors: A nationwide study
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    Hepatology Communications.2022; 6(9): 2455.     CrossRef
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    Gastroenterology.2022; 163(3): 637.     CrossRef
  • A positive faecal immunochemical test result and its association with the incidence of rheumatoid arthritis, systemic lupus erythematosus, and psoriatic arthritis: an analysis of one-million national colorectal cancer screening programme results
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  • Obesity Fact Sheet in Korea, 2021: Trends in Obesity Prevalence and Obesity-Related Comorbidity Incidence Stratified by Age from 2009 to 2019
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    Journal of Obesity & Metabolic Syndrome.2022; 31(2): 169.     CrossRef
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    Gut and Liver.2022; 16(4): 555.     CrossRef
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    Yonsei Medical Journal.2022; 63(8): 774.     CrossRef
  • Risk for Behçet’s disease gauged via high-density lipoprotein cholesterol: a nationwide population-based study in Korea
    Yeong Ho Kim, Hyun Jee Kim, Jin Woo Park, Kyung Do Han, Yong Gyu Park, Young Bok Lee, Ji Hyun Lee
    Scientific Reports.2022;[Epub]     CrossRef
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    Journal of Personalized Medicine.2022; 12(8): 1260.     CrossRef
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    Journal of Cardiothoracic Surgery.2022;[Epub]     CrossRef
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    Hepatology Research.2022; 52(12): 975.     CrossRef
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    Diabetes & Metabolism Journal.2022; 46(5): 701.     CrossRef
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    Seungwoo Cha, Sherry L. Grace, Kyungdo Han, Bongseong Kim, Nam-Jong Paik, Won-Seok Kim
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    Scientific Reports.2022;[Epub]     CrossRef
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    Kookhwan Choi, Hyun Jung Lee, Kyungdo Han, Seong-Joon Koh, Jong Pil Im, Joo Sung Kim
    Frontiers in Medicine.2022;[Epub]     CrossRef
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    Sun Young Lee, Jeong Ho Park, Young Ho Choi, Jungah Lee, Young Sun Ro, Ki Jeong Hong, Kyoung Jun Song, Sang Do Shin
    Academic Emergency Medicine.2022; 29(12): 1438.     CrossRef
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    Clinical and Molecular Hepatology.2022; 28(4): 851.     CrossRef
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    Yonsei Medical Journal.2022; 63(11): 991.     CrossRef
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    Ji‐Eun Kim, Jaesung Choi, JooYong Park, Wonshik Han, Daehee Kang, Ji‐Yeob Choi
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    Respiratory Research.2022;[Epub]     CrossRef
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    Diabetes Research and Clinical Practice.2022; 194: 110191.     CrossRef
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    Ji Youn Hong, Juhee Ahn, Sungho Won, Sung Min Kim, Young Ah Cho, Chang Yong Kim, Jae Young Sung, Da-Ae Yu, Yang Won Lee, Yong Beom Choe
    Scientific Reports.2022;[Epub]     CrossRef
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    International Journal of Cancer.2021; 148(3): 626.     CrossRef
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    Journal of Korean Medical Science.2021;[Epub]     CrossRef
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  • Effect of Institutional Case Volume on In-hospital Mortality After Living Donor Liver Transplantation: Analysis of 7073 Cases Between 2007 and 2016 in Korea
    Seokha Yoo, Eun Jin Jang, Nam-Joon Yi, Ga Hee Kim, Dal Ho Kim, Hannah Lee, Chul-Woo Jung, Ho Geol Ryu
    Transplantation.2019; 103(5): 952.     CrossRef
  • Increased risk of benign paroxysmal positional vertigo in osteoporosis: a nationwide population-based cohort study
    Hayoung Byun, Jae Ho Chung, Seung Hwan Lee, Chul Won Park, Eun Mi Kim, Inah Kim
    Scientific Reports.2019;[Epub]     CrossRef
  • Incremental economic burden associated with exudative age-related macular degeneration: a population-based study
    Siin Kim, Sang Jun Park, Seong Jun Byun, Kyu Hyung Park, Hae Sun Suh
    BMC Health Services Research.2019;[Epub]     CrossRef
  • Patients with Inflammatory Bowel Disease Are at an Increased Risk of Parkinson’s Disease: A South Korean Nationwide Population-Based Study
    Seona Park, Jihye Kim, Jaeyoung Chun, Kyungdo Han, Hosim Soh, Eun Ae Kang, Hyun Jung Lee, Jong Pil Im, Joo Sung Kim
    Journal of Clinical Medicine.2019; 8(8): 1191.     CrossRef
  • Effect of hypertension duration and blood pressure level on ischaemic stroke risk in atrial fibrillation: nationwide data covering the entire Korean population
    Tae-Hoon Kim, Pil-Sung Yang, Hee Tae Yu, Eunsun Jang, Hyejung Shin, Ha Yan Kim, Jae-Sun Uhm, Jong-Youn Kim, Jung-Hoon Sung, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung, Gregory Y H Lip
    European Heart Journal.2019; 40(10): 809.     CrossRef
  • Perioperative red blood cell transfusion and mortality following heart transplantation: A retrospective nationwide population‐based study between 2007 and 2016 in Korea
    Karam Nam, Eun Jin Jang, Ga Hee Kim, Hyung Been Yhim, Hannah Lee, Dal Ho Kim, Ho Geol Ryu
    Journal of Cardiac Surgery.2019; 34(10): 927.     CrossRef
  • The Effect of Health-Related Behaviors on Disease Progression and Mortality in Early Stages of Chronic Kidney Disease: A Korean Nationwide Population-Based Study
    Yookyung Lee, SuYeon Kwon, Jong Joo Moon, Kyungdo Han, Nam-Jong Paik, Won-Seok Kim
    Journal of Clinical Medicine.2019; 8(8): 1100.     CrossRef
  • Association of body mass index with bladder cancer risk in men depends on abdominal obesity
    Jin Bong Choi, Jung Ho Kim, Sung-Hoo Hong, Kyung-Do Han, U-Syn Ha
    World Journal of Urology.2019; 37(11): 2393.     CrossRef
  • Time‐ and Dose‐Dependent Association of Statin Use With Risk of Clinically Relevant New‐Onset Diabetes Mellitus in Primary Prevention: A Nationwide Observational Cohort Study
    Min Jung Ko, Ae Jeong Jo, Yun Jung Kim, Shin Hee Kang, Songhee Cho, Sang‐Ho Jo, Cheol‐Young Park, Sung‐Cheol Yun, Woo Je Lee, Duk‐Woo Park
    Journal of the American Heart Association.2019;[Epub]     CrossRef
  • Association of Long-term Use of Low-Dose Aspirin as Chemoprevention With Risk of Lung Cancer
    Shinhee Ye, Myeongjee Lee, Dongheon Lee, Eun-Hee Ha, Eun Mi Chun
    JAMA Network Open.2019; 2(3): e190185.     CrossRef
  • Association between BMI and risk of severe hypoglycaemia in type 2 diabetes
    J.-S. Yun, Y.-M. Park, K. Han, S.-A. Cha, Y.-B. Ahn, S.-H. Ko
    Diabetes & Metabolism.2019; 45(1): 19.     CrossRef
  • Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study
    Ji-Yeon Lee, Kyungdo Han, Eugene Han, Gyuri Kim, Hanna Cho, Kwang Joon Kim, Byung Wan Lee, Eun Seok Kang, Bong-Soo Cha, Carol Brayne, Yong-ho Lee
    The Journal of Clinical Endocrinology & Metabolism.2019; 104(7): 2942.     CrossRef
  • Increased Risk of Osteoporotic Fracture in Postgastrectomy Gastric Cancer Survivors Compared With Matched Controls: A Nationwide Cohort Study in Korea
    Dong Wook Shin, Beomseok Suh, Hyunsun Lim, Yun-Suhk Suh, Yoon Jin Choi, Su-Min Jeong, Jae Moon Yun, Sun Ok Song, Youngmin Park
    American Journal of Gastroenterology.2019; 114(11): 1735.     CrossRef
  • Metabolic syndrome is associated with an increased risk of psoriasis: A nationwide population-based study
    Ha-Na Kim, Kyungdo Han, Yong-Gyu Park, Ji Hyun Lee
    Metabolism.2019; 99: 19.     CrossRef
  • Association of Exposure to Diagnostic Low-Dose Ionizing Radiation With Risk of Cancer Among Youths in South Korea
    Jae-Young Hong, Kyungdo Han, Jin-Hyung Jung, Jung Sun Kim
    JAMA Network Open.2019; 2(9): e1910584.     CrossRef
  • Long‐term clinical outcomes in patients with autoimmune hepatitis according to treatment response in Asian country
    Jonggi Choi, Gwang Hyeon Choi, Danbi Lee, Ju Hyun Shim, Young‐Suk Lim, Han Chu Lee, Young‐Hwa Chung, Yung‐Sang Lee, Kang Mo Kim
    Liver International.2019; 39(5): 985.     CrossRef
  • Effectiveness and Safety of Direct Oral Anticoagulant for Secondary Prevention in Asians with Atrial Fibrillation
    Jiesuck Park, So-Ryoung Lee, Eue-Keun Choi, Soonil Kwon, Jin-Hyung Jung, Kyung-Do Han, Myung-Jin Cha, Sang-Bae Ko, Seil Oh, Gregory Y. H. Lip
    Journal of Clinical Medicine.2019; 8(12): 2228.     CrossRef
  • Optimal Rivaroxaban Dose in Asian Patients With Atrial Fibrillation and Normal or Mildly Impaired Renal Function
    So-Ryoung Lee, Eue-Keun Choi, Kyung-Do Han, Jin-Hyung Jung, Seil Oh, Gregory Y.H. Lip
    Stroke.2019; 50(5): 1140.     CrossRef
  • Tobacco Smoking and Alcohol Consumption Are Related to Benign Parotid Tumor: A Nested Case-Control Study Using a National Health Screening Cohort
    So Young Kim, Chanyang Min, Dong Jun Oh, Hyo Geun Choi
    Clinical and Experimental Otorhinolaryngology.2019; 12(4): 412.     CrossRef
  • Increased Risk of Diabetes in Inflammatory Bowel Disease Patients: A Nationwide Population-Based Study in Korea
    Eun Ae Kang, Kyungdo Han, Jaeyoung Chun, Hosim Soh, Seona Park, Jong Pil Im, Joo Sung Kim
    Journal of Clinical Medicine.2019; 8(3): 343.     CrossRef
  • Changes in the Diagnostic Efficiency of Thyroid Fine-Needle Aspiration Biopsy during the Era of Increased Thyroid Cancer Screening in Korea
    Young Ki Lee, Kyeong Hye Park, Young Duk Song, Taemi Youk, Joo Young Nam, Sun Ok Song, Dong Yeob Shin, Eun Jig Lee
    Cancer Research and Treatment.2019; 51(4): 1430.     CrossRef
  • Safety and Effectiveness of Contemporary P2Y 12 Inhibitors in an East Asian Population With Acute Coronary Syndrome: A Nationwide Population‐Based Cohort Study
    Ji Eun Yun, Yun Jung Kim, Ji Jeong Park, Sehee Kim, Keunhui Park, Min Soo Cho, Gi‐Byoung Nam, Duk‐Woo Park
    Journal of the American Heart Association.2019;[Epub]     CrossRef
  • Direct Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation and Low Body Weight
    So-Ryoung Lee, Eue-Keun Choi, Chan Soon Park, Kyung-Do Han, Jin-Hyung Jung, Seil Oh, Gregory Y.H. Lip
    Journal of the American College of Cardiology.2019; 73(8): 919.     CrossRef
  • Trends in varicella and herpes zoster epidemiology before and after the implementation of universal one-dose varicella vaccination over one decade in South Korea, 2003–2015
    Jae-Ki Choi, Sun Hee Park, Sanghyun Park, Su-Mi Choi, Si-Hyun Kim, Dong-Gun Lee, Jin-Hong Yoo, Jung-Hyun Choi, Jin Han Kang
    Human Vaccines & Immunotherapeutics.2019; 15(11): 2554.     CrossRef
  • Obesity Fact Sheet in Korea, 2018: Data Focusing on Waist Circumference and Obesity-Related Comorbidities
    Ga Eun Nam, Yang-Hyun Kim, Kyungdo Han, Jin-Hyung Jung, Yong Gyu Park, Kwan-Woo Lee, Eun-Jung Rhee, Jang Won Son, Seong-Su Lee, Hyuk-Sang Kwon, Won-Young Lee, Soon Jib Yoo
    Journal of Obesity & Metabolic Syndrome.2019; 28(4): 236.     CrossRef
  • Long-Term Impact of Newly Diagnosed Atrial Fibrillation During Critical Care
    Kyu Kim, Pil-Sung Yang, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Jung-Hoon Sung, Hui-Nam Pak, Moon-Hyoung Lee, Gregory Y.H. Lip, Boyoung Joung
    Chest.2019; 156(3): 518.     CrossRef
  • Correlation of Androgen Deprivation Therapy with Cognitive Dysfunction in Patients with Prostate Cancer: A Nationwide Population-Based Study Using the National Health Insurance Service Database
    Bum Sik Tae, Byung Jo Jeon, Seung Hun Shin, Hoon Choi, Jae Hyun Bae, Jae Young Park
    Cancer Research and Treatment.2019; 51(2): 593.     CrossRef
  • Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and Valvular Heart Disease
    Inki Moon, So-Ryoung Lee, Eue-Keun Choi, Euijae Lee, Jin-Hyung Jung, Kyung-Do Han, Myung-Jin Cha, Seil Oh, Gregory Y.H. Lip
    Journal of Clinical Medicine.2019; 8(10): 1624.     CrossRef
  • Relation between Baseline Height and New Diabetes Development: A Nationwide Population-Based Study
    Eun-Jung Rhee, Jung-Hwan Cho, Hyemi Kwon, Se-Eun Park, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Won-Young Lee
    Diabetes & Metabolism Journal.2019; 43(6): 794.     CrossRef
  • The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
    Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
    Diabetes & Metabolism Journal.2019; 43(2): 206.     CrossRef
  • The risk of end-stage renal disease in systemic lupus erythematosus
    Hong Sang Choi, Kyung-Do Han, Jin-Hyung Jung, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
    Medicine.2019; 98(28): e16420.     CrossRef
  • Antithrombotic Therapy in Patients With Atrial Fibrillation After Percutaneous Coronary Intervention During 2-Year Follow-Up, from a Nationwide Population Study
    Jiesuck Park, Eue-Keun Choi, Kyung-Do Han, You-Jung Choi, So-Ryoung Lee, Myung-Jin Cha, Jeehoon Kang, Kyung Woo Park, Seil Oh, Gregory Y.H. Lip
    The American Journal of Cardiology.2019; 123(12): 1921.     CrossRef
  • Outcomes After Use of Standard- and Low-Dose Non–Vitamin K Oral Anticoagulants in Asian Patients With Atrial Fibrillation
    Min Soo Cho, Ji Eun Yun, Ji Jeong Park, Yun Jung Kim, Jessie Lee, Hyungmin Kim, Duk-Woo Park, Gi-Byoung Nam
    Stroke.2019; 50(1): 110.     CrossRef
  • Association between Atrial Fibrillation, Myocardial Infarction, Heart Failure and Mortality in Patients with Nontuberculous Mycobacterial Infection: a nationwide population-based study
    Chan Soon Park, Eue-Keun Choi, Bongseong Kim, Kyung-Do Han, So-Ryoung Lee, Myung-Jin Cha, Seil Oh
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  • National practice patterns and direct medical costs for prostate cancer in Korea across a 10 year period: a nationwide population-based study using a national health insurance database
    Ho Won Kang, Seok-Joong Yun, Jae Il Chung, Hoon Choi, Jae Heon Kim, Ho Song Yu, Yun-Sok Ha, In-Chang Cho, Hyung Joon Kim, Hyun Chul Chung, Jun Sung Koh, Wun-Jae Kim, Jong-Hyock Park, Ji Youl Lee, So-Young Kim
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  • Institutional Case-Volume and Mortality After Heart Transplantation
    Karam Nam, Eun Jin Jang, Ga Hee Kim, Hannah Lee, Dal Ho Kim, Ho Geol Ryu
    International Heart Journal.2019; 60(3): 695.     CrossRef
  • Weight change is significantly associated with risk of thyroid cancer: A nationwide population-based cohort study
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    Scientific Reports.2019;[Epub]     CrossRef
  • Venous thromboembolism in relapsed or refractory multiple myeloma patients treated with lenalidomide plus dexamethasone
    Junghoon Shin, Je-Jung Lee, Kihyun Kim, Chang-Ki Min, Jeong-Ok Lee, Cheolwon Suh, Jin Seok Kim, Yoo Jin Lee, Sung-Soo Yoon, Jae-Cheol Jo, Ho Sup Lee, Soo-Mee Bang
    International Journal of Hematology.2019; 109(1): 79.     CrossRef
  • Actinic keratosis and diabetes complications: A nationwide population-based study in South Korea (2009–2015)
    YoungBok Lee, JiHyun Lee, JinYoung Choi, DongSoo Yu, KyungDo Han, Yong-Gyu Park
    Diabetes & Metabolism.2019; 45(1): 32.     CrossRef
  • Ankylosing spondylitis: A novel risk factor for atrial fibrillation — A nationwide population-based study
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    International Journal of Cardiology.2019; 275: 77.     CrossRef
  • Cancer risk among young men with weight gain after smoking cessation: A population-based cohort study
    Kyuwoong Kim, Seulggie Choi, Gyeongsil Lee, Su-Min Jeong, Sung Min Kim, Joung Sik Son, Jae-Moon Yun, Yeon-Yong Kim, Seong Yong Park, Sang Min Park
    Cancer Epidemiology.2019; 60: 86.     CrossRef
  • Effect of drug compliance on health care costs in newly-diagnosed dementia: Analysis of nationwide population-based data
    Seung-Taek Oh, Kyu-Tae Han, Won-Jung Choi, Jaesub Park
    Journal of Psychiatric Research.2019; 118: 31.     CrossRef
  • Colorectal Cancer Risks According to Sex Differences in Patients With Type II Diabetes Mellitus: A Korean Nationwide Population-Based Cohort Study
    Ji Min Lee, Kang-Moon Lee, Dae Bum Kim, Seung-Hyun Ko, Yong Gyu Park
    Clinical and Translational Gastroenterology.2019; 10(10): e00090.     CrossRef
  • Body Mass Index Variability and Long-term Risk of New-Onset Atrial Fibrillation in the General Population: A Korean Nationwide Cohort Study
    Yeong-Min Lim, Pil-Sung Yang, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Jong-Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung, Gregory Y.H. Lip
    Mayo Clinic Proceedings.2019; 94(2): 225.     CrossRef
  • Childbirth in young Korean women with previously treated breast cancer: The SMARTSHIP study
    Hak Min Lee, Bo Wook Kim, Seho Park, Sungmin Park, Jeon Eon Lee, Young Jin Choi, Sung Yong Kim, Sang Uk Woo, Hyun Jo Youn, Ilkyun Lee
    Breast Cancer Research and Treatment.2019; 176(2): 419.     CrossRef
  • Obstructive sleep apnea as a risk factor for incident end stage renal disease: a nationwide population-based cohort study from Korea
    Hong Sang Choi, Ha Yeon Kim, Kyung-Do Han, Jin-Hyung Jung, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
    Clinical and Experimental Nephrology.2019; 23(12): 1391.     CrossRef
  • Severe hypoglycemia and the risk of cardiovascular disease and mortality in type 2 diabetes: a nationwide population-based cohort study
    Jae-Seung Yun, Yong-Moon Park, Kyungdo Han, Seon-Ah Cha, Yu-Bae Ahn, Seung-Hyun Ko
    Cardiovascular Diabetology.2019;[Epub]     CrossRef
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    Kyuwoong Kim, Seulggie Choi, Jooyoung Chang, Sung Min Kim, Seon Jip Kim, Ryan Jin-Young Kim, Hyun-Jae Cho, Sang Min Park
    Scientific Reports.2019;[Epub]     CrossRef
  • Risk of Anxiety and Depression in Patients with Inflammatory Bowel Disease: A Nationwide, Population-Based Study
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    Journal of Clinical Medicine.2019; 8(5): 654.     CrossRef
  • The Effects after Implementing a Drug Utilization Review System on Contraindicated Drug use: A Systematic Review
    Heeyoung Lee, Hyea Suk Choi, Eunhee Ji
    Korean Journal of Clinical Pharmacy.2019; 29(1): 9.     CrossRef
  • Nationwide Trends in Pancreatitis and Pancreatic Cancer Risk Among Patients With Newly Diagnosed Type 2 Diabetes Receiving Dipeptidyl Peptidase 4 Inhibitors
    Minyoung Lee, Jiyu Sun, Minkyung Han, Yongin Cho, Ji-Yeon Lee, Chung Mo Nam, Eun Seok Kang
    Diabetes Care.2019; 42(11): 2057.     CrossRef
  • Dose–response relationship between cigarette smoking and risk of ulcerative colitis: a nationwide population-based study
    Seona Park, Jaeyoung Chun, Kyung-Do Han, Hosim Soh, Eun Ae Kang, Hyun Jung Lee, Jong Pil Im, Joo Sung Kim
    Journal of Gastroenterology.2019; 54(10): 881.     CrossRef
  • Is androgen deprivation therapy associated with cerebral infarction in patients with prostate cancer? A Korean nationwide population‐based propensity score matching study
    Bum Sik Tae, Byeong Jo Jeon, Hoon Choi, Jae Hyun Bae, Jae Young Park
    Cancer Medicine.2019; 8(9): 4475.     CrossRef
  • Adult lung transplantation case-volume and in-hospital and long-term mortality in Korea
    Susie Yoon, Eun Jin Jang, Ga Hee Kim, Dal Ho Kim, Tae-Yoon Lim, Hannah Lee, Ho Geol Ryu
    Journal of Cardiothoracic Surgery.2019;[Epub]     CrossRef
  • Systemic lupus erythematosus is a risk factor for cancer: a nationwide population-based study in Korea
    E.H. Bae, S.Y. Lim, K.-D. Han, J.-Hy. Jung, H.S. Choi, C.S. Kim, S.K. Ma, SW Kim
    Lupus.2019; 28(3): 317.     CrossRef
  • Association Between Drug Exposure and Occurrence of Parkinsonism in Korea: A Population-Based Case-Control Study
    Siin Kim, Sang-Myung Cheon, Hae Sun Suh
    Annals of Pharmacotherapy.2019; 53(11): 1102.     CrossRef
  • Validation of diagnostic codes of major clinical outcomes in a National Health Insurance database
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    International Journal of Arrhythmia.2019;[Epub]     CrossRef
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    The Journal of Clinical Endocrinology & Metabolism.2019; 104(11): 5633.     CrossRef
  • Prognostic influence of Korean public medical insurance system on breast cancer patients
    Ki-Tae Hwang, Young Wook Ju, Young A Kim, Jongjin Kim, Sohee Oh, Jiwoong Jung, Young Jun Chai, In Sil Choi, So Won Oh
    Annals of Surgical Treatment and Research.2019; 96(2): 58.     CrossRef
  • Effect of Case Volume on Mortality After Pediatric Liver Transplantation in Korea
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    Transplantation.2019; 103(8): 1649.     CrossRef
  • Prescription Patterns and Burden of Pediatric Asthma in Korea
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    Allergy, Asthma & Immunology Research.2019; 11(2): 280.     CrossRef
  • Increased risk of coronary heart disease and stroke in lung cancer survivors: A Korean nationwide study of 20,458 patients
    Dong Woog Yoon, Dong Wook Shin, Jong Ho Cho, Jeong Hoon Yang, Su-Min Jeong, Kyungdo Han, Sang Hyun Park
    Lung Cancer.2019; 136: 115.     CrossRef
  • Waist Circumference and All-Cause Mortality Independent of Body Mass Index in Korean Population from the National Health Insurance Health Checkup 2009–2015
    Yang-Hyun Kim, Seon Mee Kim, Kyung-Do Han, Jin-Hyung Jung, Seong-Su Lee, Sang Woo Oh, Hye Soon Park, Eun-Jung Rhee, Won-Young Lee, Soon Jib Yoo
    Journal of Clinical Medicine.2019; 8(1): 72.     CrossRef
  • Temporal trends in prevalence and antithrombotic treatment among Asians with atrial fibrillation undergoing percutaneous coronary intervention: A nationwide Korean population-based study
    Jiesuck Park, Eue-Keun Choi, Kyung-Do Han, You-jung Choi, Euijae Lee, Wonseok Choe, So-Ryoung Lee, Myung-Jin Cha, Woo-Hyun Lim, Jeehoon Kang, Kyung Woo Park, Seil Oh, Gregory Y. H. Lip, Chiara Lazzeri
    PLOS ONE.2019; 14(1): e0209593.     CrossRef
  • Factors influencing the incidence and treatment of intracranial aneurysm and subarachnoid hemorrhage: time trends and socioeconomic disparities under an universal healthcare system
    Won Kyung Lee, Chang Wan Oh, Heeyoung Lee, Kun Sei Lee, Hyeonseon Park
    Journal of NeuroInterventional Surgery.2019; 11(2): 159.     CrossRef
  • Increasing trends in hospital care burden of atrial fibrillation in Korea, 2006 through 2015
    Daehoon Kim, Pil-Sung Yang, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Jae-Sun Uhm, Jong Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung, Gregory Y H Lip
    Heart.2018; 104(24): 2010.     CrossRef
  • Appropriate Amount of Regular Exercise Is Associated with a Reduced Mortality Risk
    DA YOUNG LEE, EUN-JUNG RHEE, JUNG HWAN CHO, HYEMI KWON, SE EUN PARK, YANG-HYUN KIM, KYUNGDO HAN, YONG-KYU PARK, SOON JIB YOO, WON-YOUNG LEE
    Medicine & Science in Sports & Exercise.2018; 50(12): 2451.     CrossRef
  • The effect of continuity of care on the incidence of end-stage renal disease in patients with newly detected type 2 diabetic nephropathy: a retrospective cohort study
    Yun Jung Jang, Yoon Soo Choy, Chung Mo Nam, Ki Tae Moon, Eun-Cheol Park
    BMC Nephrology.2018;[Epub]     CrossRef
  • Increased end-stage renal disease risk in patients with inflammatory bowel disease: A nationwide population-based study
    Seona Park, Jaeyoung Chun, Kyung-Do Han, Hosim Soh, Kookhwan Choi, Ji Hye Kim, Jooyoung Lee, Changhyun Lee, Jong Pil Im, Joo Sung Kim
    World Journal of Gastroenterology.2018; 24(42): 4798.     CrossRef
  • Cardiovascular disease risk differences between bus company employees and general workers according to the Korean National Health Insurance Data
    Ji-Hoo Yook, Dong-Wook Lee, Min-Seok Kim, Yun-Chul Hong
    Annals of Occupational and Environmental Medicine.2018;[Epub]     CrossRef
  • Impact of Renal Function on Outcomes With Edoxaban in Real-World Patients With Atrial Fibrillation
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    Stroke.2018; 49(10): 2421.     CrossRef
  • Association between adult height, myocardial infarction, heart failure, stroke and death: a Korean nationwide population-based study
    Chan Soon Park, Eue-Keun Choi, Kyung-Do Han, Hyun Jung Lee, Tae-Min Rhee, So-Ryoung Lee, Myung-Jin Cha, Woo-Hyun Lim, Si-Hyuck Kang, Seil Oh
    International Journal of Epidemiology.2018; 47(1): 289.     CrossRef
  • Dietary Fat Intake and Risk of Colorectal Cancer: A Systematic Review and Meta-Analysis of Prospective Studies
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    Nutrients.2018; 10(12): 1963.     CrossRef
  • Association Between Changes in Hemoglobin Concentration and Cardiovascular Risks and All‐Cause Mortality Among Young Women
    Gyeongsil Lee, Seulggie Choi, Kyuwoong Kim, Jae‐Moon Yun, Joung Sik Son, Su‐Min Jeong, Sung Min Kim, Yeon‐Yong Kim, Seong Yong Park, Youngil Koh, Seung‐sik Hwang, Sang Min Park
    Journal of the American Heart Association.2018;[Epub]     CrossRef
  • The economic burden of rotavirus infection in South Korea from 2009 to 2012
    Kyung Suk Lee, Ye-Rin Lee, So-Youn Park, In-Hwan Oh, Donald R. Olson
    PLOS ONE.2018; 13(3): e0194120.     CrossRef
  • Incidence and death rate of pemphigus vulgaris and pemphigus foliaceus in Korea: A nationwide, population‐based study (2006–2015)
    Young Bok Lee, Ji Hyun Lee, Soo Young Lee, Jin‐Wou Kim, Dong Soo Yu, Kyung Do Han, Yong Gyu Park
    The Journal of Dermatology.2018; 45(12): 1396.     CrossRef
  • Protective Effect of Metformin Against Thyroid Cancer Development: A Population-Based Study in Korea
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    Thyroid.2018; 28(7): 864.     CrossRef
  • Association of oral ciprofloxacin, levofloxacin, ofloxacin and moxifloxacin with the risk of serious ventricular arrhythmia: a nationwide cohort study in Korea
    Yongil Cho, Hyun Soo Park
    BMJ Open.2018; 8(9): e020974.     CrossRef
  • The risk of alopecia areata and other related autoimmune diseases in patients with sleep disorders: a Korean population–based retrospective cohort study
    Hyun-Min Seo, Tae Lim Kim, Joung Soo Kim
    Sleep.2018;[Epub]     CrossRef
  • Evaluation of relationships between onychomycosis and vascular diseases using sequential pattern mining
    Chul Hwan Bang, Jae Woong Yoon, Hyun Ji Lee, Jun Young Lee, Young Min Park, Suk Jun Lee, Ji Hyun Lee
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  • Age Threshold for Ischemic Stroke Risk in Atrial Fibrillation
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    Stroke.2018; 49(8): 1872.     CrossRef
  • Variations of Prevalence and Incidence of Atrial Fibrillation and Oral Anticoagulation Rate According to Different Analysis Approaches
    Pil-Sung Yang, Soorack Ryu, Daehoon Kim, Eunsun Jang, Hee Tae Yu, Tae-Hoon Kim, Jinseub Hwang, Boyoung Joung, Gregory Y. H. Lip
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  • Reciprocal relationship between herpes zoster and cardiovascular diseases: A nationwide population‐based case–control study in Korea
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    The Journal of Dermatology.2018; 45(11): 1312.     CrossRef
  • Hypertension and risk of psoriasis incidence: An 11-year nationwide population-based cohort study
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Efficacy of the Smartphone-Based Glucose Management Application Stratified by User Satisfaction
Hun-Sung Kim, Wona Choi, Eun Kyoung Baek, Yun A Kim, So Jung Yang, In Young Choi, Kun-Ho Yoon, Jae-Hyoung Cho
Diabetes Metab J. 2014;38(3):204-210.   Published online June 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.3.204
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AbstractAbstract PDFPubReader   ePub   
Background

We aimed to assess the efficacy of the smartphone-based health application for glucose control and patient satisfaction with the mobile network system used for glucose self-monitoring.

Methods

Thirty-five patients were provided with a smartphone device, and self-measured blood glucose data were automatically transferred to the medical staff through the smartphone application over the course of 12 weeks. The smartphone user group was divided into two subgroups (more satisfied group vs. less satisfied group) based on the results of questionnaire surveys regarding satisfaction, comfort, convenience, and functionality, as well as their willingness to use the smartphone application in the future. The control group was set up via a review of electronic medical records by group matching in terms of age, sex, doctor in charge, and glycated hemoglobin (HbA1c).

Results

Both the smartphone group and the control group showed a tendency towards a decrease in the HbA1c level after 3 months (7.7%±0.7% to 7.5%±0.7%, P=0.077). In the more satisfied group (n=27), the HbA1c level decreased from 7.7%±0.8% to 7.3%±0.6% (P=0.001), whereas in the less satisfied group (n=8), the HbA1c result increased from 7.7%±0.4% to 8.1%±0.5% (P=0.062), showing values much worse than that of the no-smartphone control group (from 7.7%±0.5% to 7.7%±0.7%, P=0.093).

Conclusion

In addition to medical feedback, device and network-related patient satisfaction play a crucial role in blood glucose management. Therefore, for the smartphone app-based blood glucose monitoring to be effective, it is essential to provide the patient with a well-functioning high quality tool capable of increasing patient satisfaction and willingness to use.

Citations

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Current Status of Glycemic Control of Patients with Diabetes in Korea: The Fifth Korea National Health and Nutrition Examination Survey
Ja Young Jeon, Dae Jung Kim, Seung-Hyun Ko, Hyuk-Sang Kwon, Soo Lim, Sung Hee Choi, Chul Sik Kim, Jee Hyun An, Nan Hee Kim, Jong Chul Won, Jae Hyeon Kim, Bong-Yun Cha, Kee-Ho Song
Diabetes Metab J. 2014;38(3):197-203.   Published online June 17, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.3.197
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AbstractAbstract PDFPubReader   ePub   
Background

The Korea National Health and Nutrition Examination Survey (KNHANES) III (2005) reported that 22.9% of individuals with diabetes have a glycated hemoglobin (HbA1c) <6.5% and that 43.5% have an HbA1c <7%. We investigated the levels of glycemic control and the factors associated with glycemic control using data from the KNHANES V (2010 to 2012).

Methods

Subjects with diabetes diagnosed by a physician or those taking antidiabetic medications were classified as individuals with known diabetes. Of 1,498 subjects aged ≥30 years with diabetes, we excluded 157 individuals who were missing HbA1c data. A total of 1,341 subjects were included in the final analysis.

Results

The prevalence of known diabetes was 7.7% (n=1,498, estimated to be 2.32 million people). The proportions of well-controlled diabetes meeting a HbA1c goal of <6.5% and <7% were 27% and 45.6%, respectively. HbA1c increased as the duration of diabetes increased. HbA1c in subjects with a duration of diabetes ≤5 years was lower than in subjects with a duration >5 years. HbA1c in the group taking only oral hypoglycemic agents (OHAs) was significantly lower than that in the group administered only insulin or OHA and insulin in combination. In logistic regression analysis, a longer duration of diabetes, insulin use and the absence of chronic renal failure were associated with HbA1c levels >6.5%.

Conclusion

The level of adequate glycemic control was similar to but slightly improved compared with previous levels. The glycemic control of long-standing diabetes patients is more difficult even though they receive insulin treatment.

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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
Seung-Hyun Ko, Hyuk-Sang Kwon, Dae Jung Kim, Jae Hyeon Kim, Nan Hee Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Kyungdo Han, Yong-Moon Park, Bong-Yun Cha
Diabetes Metab J. 2014;38(1):51-57.   Published online February 19, 2014
DOI: https://doi.org/10.4093/dmj.2014.38.1.51
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AbstractAbstract PDFPubReader   ePub   
Background

We investigated the prevalence, awareness, treatment, and control rate of hypertension in Korean adults with diabetes using nationally representative data.

Methods

Using data of 5,105 adults from the fifth Korea National Health and Nutrition Examination Survey in 2011 (4,389 nondiabetes mellitus [non-DM]), 242 newly diagnosed with DM (new-DM), and 474 previously diagnosed with DM (known-DM), we analyzed the prevalence of hypertension (mean systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive medication) and control rate of hypertension (blood pressure [BP] <130/80 mm Hg).

Results

The prevalence of hypertension in diabetic adults was 54.6% (44.4% in new-DM and 62.6% in known-DM, P<0.0001 and P<0.0001, respectively) compared with non-DM adults (26.2%). Compared to non-DM, awareness (85.7%, P<0.001) and treatment (97.0%, P=0.020) rates were higher in known-DM, whereas no differences were found between new-DM and non-DM. Control rate among all hypertensive subjects was lower in new-DM (14.9%), compared to non-DM (35.1%, P<0.001) and known-DM (33.3%, P=0.004). Control rate among treated subjects was also lower in new-DM (25.2%), compared to non-DM (68.4%, P<0.0001) and known-DM (39.9%, P<0.0001).

Conclusion

Higher prevalence and low control rate of hypertension in adults with diabetes suggest that stringent efforts are needed to control BP in patients with diabetes, particularly in newly diagnosed diabetic patients.

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Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c
Ja Young Jeon, Seung-Hyun Ko, Hyuk-Sang Kwon, Nan Hee Kim, Jae Hyeon Kim, Chul Sik Kim, Kee-Ho Song, Jong Chul Won, Soo Lim, Sung Hee Choi, Myoung-jin Jang, Yuna Kim, Kyungwon Oh, Dae Jung Kim, Bong-Yun Cha
Diabetes Metab J. 2013;37(5):349-357.   Published online October 17, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.5.349
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AbstractAbstract PDFPubReader   ePub   
Background

Due to the inconvenience of performing oral glucose tolerance tests and day to day variability in glucose level, glycated hemoglobin (HbA1c) has been recommended by the American Diabetes Association as a method to diagnose diabetes. In addition, the Korean Diabetes Association has also recommended the use of HbA1c as a diagnostic test for diabetes. In this study, we evaluated the prevalence of diabetes according to fasting plasma glucose (FPG) level only or the combination of FPG and HbA1c tests.

Methods

Data from the 2011 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. Among 5,811 subjects aged 30 years or older, 5,020 were selected after excluding the data of fasting time <8 hours, missing values from fasting glucose or HbA1c level, previous diagnosis of diabetes made by physicians, or current use of antidiabetic medications. Diabetes was defined as FPG ≥126 mg/dL, previous diagnosis of diabetes made by a medical doctor, current use of antidiabetic medications, and/or HbA1c ≥6.5%. Prediabetes was defined as FPG of 100 to 125 mg/dL and/or HbA1c of 5.7% to 6.4%.

Results

When we used FPG only, the prevalence of diabetes and prediabetes were 10.5% (men, 12.6%; women, 8.5%) and 19.3% (men, 23.8%; women, 14.9%), respectively. When HbA1c was included as a diagnostic test, the prevalence of diabetes and prediabetes increased to 12.4% (men, 14.5%; women, 10.4%) and 38.3% (men, 41%; women, 35.7%), respectively. Participants with HbA1c ≥6.5% and fasting glucose level <126 mg/dL were older and had lower estimated glomerular filtration rate.

Conclusion

We concluded that using fasting glucose level only may result in an underestimation of diabetes and prediabetes. HbA1c is an acceptable complementary diagnostic test for diabetes in Korean patients. However, national standardization is needed to order to use HbA1c as a diagnostic method of diabetes and prediabetes.

Citations

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Review
Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes "Diabetes in Korea 2007"
Ie Byung Park, Jaiyong Kim, Dae Jung Kim, Choon Hee Chung, Jee-Young Oh, Seok Won Park, Juneyoung Lee, Kyung Mook Choi, Kyung Wan Min, Jeong Hyun Park, Hyun Shik Son, Chul Woo Ahn, Hwayoung Kim, Sunhee Lee, Im Bong Lee, Injeoung Choi, Sei Hyun Baik
Diabetes Metab J. 2013;37(4):233-239.   Published online August 14, 2013
DOI: https://doi.org/10.4093/dmj.2013.37.4.233
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AbstractAbstract PDFPubReader   ePub   

There are many studies on the prevalence, clinical characteristics, and economic burden of diabetes across the past four decades in Korea. Nonetheless, there is a dearth of nationwide study regarding diabetes encompassing all age group. Eight years ago, the Committee on the Epidemiology of Diabetes Mellitus of Korean Diabetes Association collaborated with Health Insurance Review & Assessment Service to evaluate the status of diabetes care and characteristics in diabetic patients in Korea. In 2007, the collaborative task force team published a comprehensive survey titled "Diabetes in Korea 2007." In this review, we reappraise the diabetic epidemics from the joint report and suggest further studies that are needed to be investigated in the future.

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Original Articles
Severe Hypoglycemia Is a Serious Complication and Becoming an Economic Burden in Diabetes
Won Chul Ha, Su Jin Oh, Ji Hyun Kim, Jung Min Lee, Sang Ah Chang, Tae Seo Sohn, Hyun Shik Son
Diabetes Metab J. 2012;36(4):280-284.   Published online August 20, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.4.280
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AbstractAbstract PDFPubReader   ePub   
Background

The prevalence of hypoglycemia is increasing due to the growing incidence of diabetes and the latest strict guidelines for glycated hemoglobin (HbA1c) levels under 7%. This study examined the clinical characteristics, causal factors, and medical costs of severely hypoglycemic patients in an emergency room (ER) of Uijeongbu St. Mary's Hospital.

Methods

The study consisted of a retrospective analysis of the characteristics, risk factors, and medical costs of 320 severely hypoglycemic patients with diabetes who presented to an ER of Uijeongbu St. Mary's Hospital from January 1, 2006 to December 31, 2009.

Results

Most hypoglycemic patients (87.5%, 280/320) were over 60 years old with a mean age of 69.5±10.9 years and a mean HbA1c level of 6.95±1.46%. Mean serum glucose as noted in the ER was 37.9±34.5 mg/dL. Renal function was decreased, serum creatinine was 2.0±2.1 mg/dL and estimated glomerular filtration rate (eGFR) was 48.0±33.6 mL/min/1.73 m2. In addition, hypoglycemic patients typically were taking sulfonylureas or insulin and a variety of other medications, and had a long history of diabetes.

Conclusion

Severe hypoglycemia is frequent in older diabetic patients, subjects with low HbA1c levels, and nephropathic patients. Therefore, personalized attention is warranted, especially in long-term diabetics with multiple comorbidities who may not have been properly educated or may need re-education for hypoglycemia.

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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)
Yong Jun Choi, Min Suk Lee, So Yeon An, Tae Ho Kim, Seung Jin Han, Hae Jin Kim, Yoon-Sok Chung, Kwan Woo Lee, Dae Jung Kim
Diabetes Metab J. 2011;35(6):587-594.   Published online December 26, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.6.587
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AbstractAbstract PDFPubReader   ePub   
Background

Diabetes is a major health problem in Korea. However, interest in the quality of life in patients with diabetes is low. We examined the effects of diabetes on health-related quality of life (HRQoL) and compared it with HRQoL in the general Korean population using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) (2007-2009).

Methods

Using KNHANES IV data, we compared EuroQol (EQ)-5D and EQ-visual analogue scale (VAS) scores after adjusting for sociodemographic and psychosocial factors as well as for comorbidities (hypertension, heart disease, stroke, arthritis, and chronic renal disease). Logistic regressions were used to explore determinants for the lowest quintile HRQoL scales in the diabetes group.

Results

The mean age of the 14,441 enrolled subjects (6,129 men and 8,312 women) was 52.5±14.5 years. The mean EQ-5D and EQ-VAS scores were significantly lower in the diabetes group (EQ-5D. 0.87; EQ-VAS, 71.94) than in the non-diabetes group (EQ-5D, 0.94; EQ-VAS, 77.40) (P<0.001). Self-reported depressive symptom had a significant effect on lowering the EQ-VAS (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1 to 2.6) in the diabetes group. Stress level had a significant effect in lowering both the EQ-5D (OR, 2.0; 95% CI, 1.3 to 2.9) and the EQ-VAS (OR, 1.9; 95% CI, 1.3 to 2.9). HbA1c, diabetes duration, and treatment modalities had no significant effect on lowering HRQoL.

Conclusion

Diabetes was clearly associated with impaired HRQoL compared with the non-diabetic population regardless of comorbidities. Therapeutic approaches should focus much more on the subjective perception of health in patients with diabetes.

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A Survey on Ubiquitous Healthcare Service Demand among Diabetic Patients
Soo Lim, So-Youn Kim, Jung Im Kim, Min Kyung Kwon, Sei Jin Min, Soo Young Yoo, Seon Mee Kang, Hong Il Kim, Hye Seung Jung, Kyong Soo Park, Jun Oh Ryu, Hayley Shin, Hak Chul Jang
Diabetes Metab J. 2011;35(1):50-57.   Published online February 28, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.1.50
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AbstractAbstract PDFPubReader   ePub   
Background

Advanced information technology can be used when developing diagnostic and treatment strategies to provide better care for diabetic patients. However, the levels of need and demand for the use of technological advances have not been investigated in diabetic patients. We proposed and developed an individualized, ubiquitous (U)-healthcare service using advanced information technology for more effective glucose control. Prior to our service initiation, we surveyed patient needs and other pertinent information.

Methods

During August 2009, we conducted a 34-item questionnaire survey among patients with diabetes who were older than 40 years in two certain hospitals in Korea.

Results

The mean age of the 228 participants was 61.2±9 years, and males made up 49.1% of the sample. Seventy-one percent replied that they wanted individualized healthcare service, and they also wanted their health information to be delivered through mobile devices such as a cellular phone or a personal digital assistant (40.4%). Most patients had never heard of U-healthcare services (81.1%); however, after explaining the concept, 71.1% of participants responded that they would use the service if it was provided. Despite their willingness, participants were concerned about technical difficulty in using the service (26.3%) as well as the cost of the service (29.8%).

Conclusion

The current study suggests that more than 70% of diabetic patients are interested in using U-healthcare services. To encourage widespread use, the application program or device of U-healthcare services should be simple, easy to use and affordable while also including a policy for the protection of private information.

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Reviews
Ubiquitous Diabetes Management System via Interactive Communication Based on Information Technologies: Clinical Effects and Perspectives
Jae-Hyoung Cho, Hun-Sung Kim, Jae-Hoon Han, Jin-Hee Lee, Jeong-Ah Oh, Yoon-Hee Choi, Kun-Ho Yoon
Korean Diabetes J. 2010;34(5):267-273.   Published online October 31, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.5.267
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AbstractAbstract PDFPubReader   ePub   

New diabetes management systems based on interactive communication have been introduced recently, accompanying rapid advances in information technology; these systems are referred to as "ubiquitous diabetes management systems." In such ubiquitous systems, patients and medical teams can communicate via Internet or telecommunications, with patients uploading their glucose data and personal information, and medical teams sending optimal feedback. Clinical evidence from both long-term and short-term trials has been reported by some researchers. Such systems appear to be effective not only in reducing the levels of HbA1c but also in stabilizing glucose control. However, most notably, evidence for the cost-effectiveness of such a system should be demonstrated before it can be propagated out to the general population in actual clinical practice. To establish a cost-effective model, various types of clinical decision supporting software designed to reduce the labor time of physicians must first be developed. A number of sensors and devices for monitoring patients' data are expected to be available in the near future; thus, methods for automatic interconnections between devices and web charts were also developed. Further investigations to demonstrate the clinical outcomes of such a system should be conducted, hopefully leading to a new paradigm of diabetes management.

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Epidemiologic Characteristics of Diabetes Mellitus in Korea: Current Status of Diabetic Patients Using Korean Health Insurance Database.
Ie Byung Park, Sei Hyun Baik
Korean Diabetes J. 2009;33(5):357-362.   Published online October 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.5.357
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AbstractAbstract PDF
The aim of article is to introduce the current status of diabetes care and characteristics in diabetic patients in Korea, which is a joint report by Korean Diabetes Association (KDA) and Health Insurance Review Agency (HIRA) ("Diabetes in Korea 2007") and to review the recent published data about the current status of diabetes mellitus in Korea.

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Original Articles
Effects of 'Ubiquitous Healthcare' on the Ability of Self-Management in Elderly Diabetic Patients.
Sung Hoon Yu, Sun Hee Kim, So Yeon Kim, Sung Hee Choi, Soo Lim, Yoon Seok Chang, Hak Jong Lee, Young Joo Park, Hak Chul Jang
Korean Diabetes J. 2009;33(1):58-64.   Published online February 1, 2009
DOI: https://doi.org/10.4093/kdj.2009.33.1.58
  • 3,909 View
  • 40 Download
  • 5 Crossref
AbstractAbstract PDF
BACKGROUND
The need for a new healthcare system is growing due to the paradigm shift from health supervision to health maintenance. Previously, we performed a pilot study that examined the effectiveness of a ubiquitous healthcare (U-healthcare) diabetes management program which consists of self-monitoring of blood glucose (SMBG) and mobile phone services for elderly patients with type 2 diabetes mellitus. In this study, we investigated the effect of a diabetes management program using U-healthcare based on the self-care skills of elderly patients with diabetes mellitus. METHODS: From July to October 2005, 17 patients were recruited and provided with a blood glucometer with the ZigBee module and a mobile phone. In addition, the patients' understanding of diabetes self-care skills was examined at the beginning and end of the study. At the end of the study, we determined the level of patient satisfaction regarding U-healthcare services. RESULTS: The patients' test scores on their understanding of diabetes mellitus improved from 57.2 +/- 20.7 to 72.7 +/- 13.4%. Specifically, patient knowledge of the basic principles for a proper diabetic diet (52.9% vs. 82.4%, P = 0.046), foods that influence blood sugar level (41.2% vs. 76.5%, P = 0.007) and the influence of beverage choice (41.2% vs. 64.7%, P = 0.007), all increased. In addition, a significant increase in knowledge of living standards regarding diabetes mellitus was observed (64.7% vs. 88.2%, P = 0.0032). CONCLUSION: We conclude that the U-healthcare incorporating SMBG could be promising, as it improves self-management skills of diabetes mellitus patients, as well as their understanding of the disease.

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Current Status of the Continuity of Ambulatory Diabetes Care and its Impact on Health Outcomes and Medical Cost in Korea Using National Health Insurance Database.
Jaiyong Kim, Hyeyoung Kim, Hwayoung Kim, Kyung Wan Min, Seok Won Park, Ie Byung Park, Jeong Hyun Park, Sei Hyun Baik, Hyun Shik Son, Chul Woo Ahn, Jee Young Oh, Sunhee Lee, Juneyoung Lee, Choon Hee Chung, Kyung Mook Choi, Injeoung Choi, Dae Jung Kim
Korean Diabetes J. 2006;30(5):377-387.   Published online September 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.5.377
  • 4,121 View
  • 52 Download
  • 22 Crossref
AbstractAbstract PDF
BACKGROUND
The continuity of care in chronic diseases, especially in diabetes, was emphasized from many studies. But large scale studies with long-term observation which confirm the impact of continuity of care on health outcomes are rare. This study tried national level 3 year observation to find differences in hospitalization, mortality and medical costs among patient groups with different utilization pattern. METHODS: The 1,088,564 patients with diabetes diagnosis and diabetes drug prescription in 2002, from 20 to 79 years old, and survived until the end of 2004 were included. Annual drug prescription days, number of visited clinics and quarterly continuity of care were measured. Gender, age group, living area, health insurance premium level (as a proxy of the income level), years of first DM diagnosis, five co-morbidities (hypertension, heart disease, stroke, renal disease, admission with DM), hospitalization experience and the type of main attending clinic were adjusted. Hospitalization, mortality and high costs group (top quintile) in 2005 were predicted by multiple logistic regression model. RESULTS: Patients who failed in continuity of care in 2003 and 2004 showed higher hospitalization (OR =1.29), higher mortality (OR =1.75) and they are more likely to be high costs group (OR =1.34) in 2005 than who fulfilled the continuity of care. Patients who have single attending clinic also showed lower hospitalization, lower mortality and lower cost. Completeness in diabetic drug prescription were correlated with lower hospitalization, lower mortality but with higher cost. Possible cost saving from continual care with single attending clinic was estimated at Won 417 billion (Dollar 1 = Won 943.7). Possible expenditure from complete drug prescription was Won 228 billion. So, net saving was Won 139 billion in our study population. CONCLUSION: Continual care and single attending clinic saves patient's life and national costs. Fragmented primary care system in Korea should be reformed for more effective care of chronic diseases. National Health Insurance Database in Korea enables nationwide long-term observation study which overcomes the many limitations found in hospital-based studies and cross-sectional surveys.

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Glycemic Control and Health Behaviors through Diabetes Mellitus Education in a Clinic.
Kyeong Soon Chang, Kwan Lee, Hyun Sul Lim
Korean Diabetes J. 2006;30(1):73-81.   Published online January 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.1.73
  • 2,849 View
  • 33 Download
  • 4 Crossref
AbstractAbstract PDF
BACKGROUND
This study was carried out to examine the changes in the health behaviors and glycemic control before and after administering a Diabetes Mellitus (DM) education program in a clinic. METHODS: The author conducted a questionnaire and analyzed the blood chemistry with the fasting plasma blood sugar (FBS) and hemoglobin A1c (HbA1c) level of 80 patients in a clinic for 6 months from February to July 2004. The study group was divided into a poorly controlled (PC) group and well-controlled (WC) group according to the FBS or HbA1c level. The author then educated the subjects about general knowledges for DM over a 6-month period. The changes in the results before and after the DM education were measured as the changes in the health behaviors along with the changes in the FBS, and HbA1c levels. RESULTS: The study subjects contained 20 males and 20 females in each groups, and the major age group was the fifth decade (22 cases, 27.5%). The mean values for the total health behavior scores after the DM education program in the PC and WC group were 16.2 +/- 1.9, and 16.2 +/- 1.7 respectively, and were significantly higher than that before the education program (11.4 +/- 2.1, 15.3 +/- 1.9, P < 0.05). The mean FBS levels after the DM education program in the PC and WC groups were 130.2 +/- 22.8 mg/dL, and 116.2 +/- 16.6 mg/dL respectively, and was significantly lower than that before the education program (186.3 +/- 33.5 mg/dL, 135.3 +/- 16.3 mg/dL, P < 0.05). The mean HbA1c levels after the DM education program in the PC and WC groups were 7.0 +/- 0.8%, and 6.2 +/- 0.4% respectively, which were significantly lower than that before the education program (9.2 +/- 1.4%, 6.5 +/- 0.4%, P < 0.05). CONCLUSION: This study suggests that a DM education program in a clinic is effective in improving the health behaviors and laboratory findings in DM patients.

Citations

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Insulin Resistance and Related Factors in the Healthy Young Men.
Seok Won Park, Yoon Sok Chung, Yong Seok Yun, Bong Soo Cha, Young Duk Song, Hyun Chul Lee, Kap Bum Huh
Korean Diabetes J. 1998;22(4):504-512.   Published online January 1, 2001
  • 1,643 View
  • 17 Download
AbstractAbstract PDF
BACKGROUND
Resistance to insulin-stimulated glucose uptake is present in the majority of patients with obesity, glucose intolerance, hypertension, dyslipidemia, and coronary artery disease. It is known that values for insulin-stimulated glucose uptake(insulin sensitivity) vary widely within individuals with normal glucose tolerance. We investigated the variations in insulin sensitivity and related factors in the nonobese healthy young men. METHODS: Insulin sensitivity was considered as whole body insulin-stimulated glucose uptake rate(M), determined by euglycemic hyperinsulinemic clamp technique in 44 non-obese healthy young men with normal glucose tolerance. Plasma glucose, insulin, and C-peptide concentrations after a standard oral glucose tolerance test and total cholesterol, triglyceride, and HDL-cholesterol levels were measured after 12-hours fasting. The subjects were divided into four quartiles based on the insulin sensitivity (M) and their clinical and biochemical characteristics were compared. RESULTS: Glucose disposal rates (M-values) were ranged from 4.14 to 11.06 mg/kg/min and distributed normally. The plasma glucose levels were not different between quartiles but plasma insulin levels of quartile 1 were significantly higher than the other three quartiles during oral glucose tolerance test. There was a curvilinear relationship between insulin sensitivity and acute insulin response (Ins[o-30]) to oral glucose challenge. There were negative cnrrelations between insulin sensitivity and BMI, percent ideal body weight, WHR, body fat content, fasting insulin level, insulin response area during OGTT, and fasting serum triglyceride level. HDL-cholesterol concentration was positively correlated with insulin sensitivity. In multiple linear regression analysis, body fat content, fasting insulin, and HDL-cholesterol were independent variables, which were related to the insulin sensitivity. CONCLUSION: There were considerable variations in insulin sensitivity in the nonobese healthy young men with normal glucose tolerance and the related independent factors were body fat content, fasting insulin, and HDL-cholesterol cancentrations.

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