Diabetes & Metabolism Journal

Original Articles

Complications
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

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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.

Citations

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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
Journal of Hypertension.2026;[Epub] CrossRef
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
Addressing Inequities in Early‐Onset Diabetic Kidney Failure in Australia: A Response to Ellis et al.
Gokhan Koker
Nephrology.2025;[Epub] CrossRef
An Overview of Sex-Based Differences in the Onset and Progression of DKD in the Well-Known Model, ZSF1 Rats
Arunita Chatterjee, Sharma S. Prabhakar
Life.2025; 15(10): 1627. CrossRef
Electroacupuncture ameliorates glycolipid metabolism disorder in skeletal muscle of type 2 diabetic rats via modulation of the AMPK/PGC-1α/TFAM signaling pathway
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

Complications
Burden of End-Stage Kidney Disease by Type 2 Diabetes Mellitus Status in South Korea: A Nationwide Epidemiologic Study: Jwa-Kyung Kim, Han Na Jung, Bum Jun Kim, Boram Han, Ji Hye Huh, Eun Roh, Joo-Hee Kim, Kyung-Do Han, Jun Goo Kang; Diabetes Metab J. 2025;49(3):498-506. Published online March 6, 2025; DOI: https://doi.org/10.4093/dmj.2024.0443

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Background
Patients with diabetes are known to be at high risk for end-stage kidney disease (ESKD), but the accurate annual risk data for new-onset ESKD is still limited. In South Korea, the prevalence and incidence of ESKD are increasing more rapidly compared to the global average. This study aimed to determine the incidence rate (IR) of ESKD by diabetes status from 2012 to 2022.
Methods
Using data from the Korean National Health Insurance Service, we calculated the IR and hazard ratio (HR) for newonset ESKD in the general population. Individuals were categorized based on diabetes status into nondiabetes, impaired fasting glucose (IFG), diabetes duration <5 and ≥5 years.
Results
Among the participants, 67.6% were nondiabetic, 22.3% had IFG, and 10% had diabetes. In Korea, the IRs of ESKD were 139 per million population (pmp) for nondiabetes, 188 pmp for IFG, 632 pmp for diabetes <5 years, and 3,403 pmp for diabetes ≥5 years. An advanced estimated glomerular filtration rate (eGFR) category was the strongest risk factor for ESKD development. However, even in patients with normal renal function, those with long-standing diabetes had a 14-fold higher risk of ESKD compared to nondiabetic individuals. The risk of ESKD associated with diabetes increased exponentially with declining renal function. Notably, IFG showed an increasing tendency for ESKD in younger patients (<65 years) with early-stage chronic kidney disease (CKD; eGFR ≥60 mL/min/1.73 m²).
Conclusion
Longer diabetes duration amplifies ESKD risk, particularly as renal function declines. Even in patients with normal renal function, long-standing diabetes significantly increases ESKD risk, while IFG is associated with elevated risk only in younger individuals with early-stage CKD.

Citations

Citations to this article as recorded by

Development and validation of a machine learning model to predict comorbid hypertension in patients with type 2 diabetes
Hailu Yang, Changfeng Fan, Chunyan Liu
Frontiers in Medicine.2026;[Epub] CrossRef

Complications
Connection between Impaired Fasting Glucose or Type 2 Diabetes Mellitus and Sepsis: A 10-Year Observational Data from the National Health Screening Cohort: Eun Hwa Lee, Kyoung Hwa Lee, Kyu-na Lee, Yebin Park, Kyung Do Han, Sang Hoon Han; Diabetes Metab J. 2025;49(3):485-497. Published online February 17, 2025; DOI: https://doi.org/10.4093/dmj.2024.0387

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Background
The mortality of sepsis without direct drugs is high. The association between prediabetes, based on a single fasting glucose (FG), or long-term type 2 diabetes mellitus (T2DM) and sepsis remains unclear.
Methods
Of the adults aged ≥20 years who were included in the National Health Screening Program (NHSP) in 2009, 40% were randomly sampled. After excluding patients with type 1 diabetes mellitus, with missing information, and who were diagnosed with sepsis during the wash-out (between 2001 and the NHSP) or 1-year lag period, a cohort comprised of 3,863,323 examinees. Body mass index (BMI) measurements, FG tests, and self-reported questionnaires on health-related behaviors were conducted. Individual information was followed up until 2020 and censored upon the first occurrence of sepsis or death. The incidence of sepsis was compared using a multivariable regression adjusted for age, sex, income, BMI, smoking, drinking, physical activity levels, and chronic diseases.
Results
The cohort was divided into those with normal FG (n=2,675,476), impaired fasting glucose (IFG) (n=890,402, 23.0%), T2DM <5 years (n=212,391, 5.5%), or T2DM for ≥5 years (n=85,054, 2.2%). The groups with IFG (adjusted hazard ratio [aHR], 1.03; 95% confidence interval [CI], 1.01 to 1.05), T2DM <5 years (aHR, 1.43; 95% CI, 1.40 to 1.47), and T2DM for ≥5 years (aHR, 1.82; 95% CI, 1.77 to 1.87) exhibited significantly higher incidence of sepsis (P<0.001), with the greatest risk in patients with T2DM aged <40 years (aHR, 1.96; 95% CI, 1.71 to 2.25).
Conclusion
Patients with long-standing and young-onset T2DM show a substantially high risk of sepsis, emphasizing the need for infection prevention and vaccination.

Citations

Citations to this article as recorded by

Association Between Blood Glucose Variability and Clinical Outcomes in Patients With Sepsis: A Systematic Review and Meta‐Analysis
Gelan Miao, Rui Lu, Tanyong Pipanmekaporn, Srisuluk Kacha, Atirut Supphapipat, Natsuda Phothikun, Phut Jewprasertpan, Kaweesak Chittawatanarat
Diabetes/Metabolism Research and Reviews.2026;[Epub] CrossRef
Simultaneous assessment of stress hyperglycemia ratio and glucose variability to predict all-cause mortality in sepsis patients across different glucose metabolic states: an observational cohort study with interpretable machine learning approach
Fuxu Wang, Yu Guo, Chucheng Jiao, Shuangmei Zhao, Liutao Sui, Zhi Mao, Ruogu Lu, Rongyao Hou, Xiaoyan Zhu
International Journal of Surgery.2026; 112(1): 1219. CrossRef
Forecasting diabetes and sepsis mortality trends using advanced time-series models in United States from 1999 to 2030
Gabriele Volucke, Brandon Xian Ch’ng, Moaz Ahmad, Syed Muhammad Ali Hassnain, Toqeer Ahmed, Khadija Khizar Khan, Obaid Ur Rahman, Rowena Rachel George, Mustafa Elhaj, Syed Anjum Gardezi, Muhammad Azhar Waheed Khan, Abdulqadir J. Nashwan, Eeshal Zulfiqar,
Journal of Diabetes & Metabolic Disorders.2026;[Epub] CrossRef
Prevalence and incidence of infections among people with type 2 diabetes: a systematic review and meta-analysis
Xue-Lei Fu, Wen-Jun Chen, Hui-Mei Zhao, Meng-Di Li, Meng-Yi Zhuang, Yang Xiao, Bei Wu, Jia Guo
Journal of Global Health.2026;[Epub] CrossRef
Association between a Single-time Measurement of Fatty Liver Index and Occurrence of Sepsis among Individuals without Excessive Alcohol Consumption
Dayeong Kim, Sang Hoon Han, Eun Hwa Lee, Hye Seong, Kyu-na Lee, Yebin Park, Kyung-Do Han
Infection & Chemotherapy.2025; 57(3): 389. CrossRef
Impact of Diabetes on Clinical Characteristics and Prognosis in Sepsis: A Retrospective Study
Wen-Wen Han, Jian-Jiang Fang
Journal of Inflammation Research.2025; Volume 18: 13823. CrossRef

Metabolic Risk/Epidemiology
2023 Diabetic Kidney Disease Fact Sheet in Korea: Nam Hoon Kim, Mi-Hae Seo, Jin Hyung Jung, Kyung Do Han, Mi Kyung Kim, Nan Hee Kim, on Behalf of Diabetic Kidney Disease Research Group of the Korean Diabetes Association; Diabetes Metab J. 2024;48(3):463-472. Published online March 19, 2024; DOI: https://doi.org/10.4093/dmj.2023.0310

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Background
To investigate the prevalence, incidence, comorbidities, and management status of diabetic kidney disease (DKD) and diabetes-related end-stage kidney disease (ESKD) in South Korea.
Methods
We used the Korea National Health and Nutrition Examination Survey data (2019 to 2021, n=2,665) for the evaluation of prevalence, comorbidities, control rate of glycemia and comorbidities in DKD, and the Korean Health Insurance Service-customized database (2008 to 2019, n=3,950,857) for the evaluation of trends in the incidence and prevalence rate of diabetes-related ESKD, renin-angiotensin system (RAS) blockers and sodium glucose cotransporter 2 (SGLT2) inhibitors use for DKD, and the risk of atherosclerotic cardiovascular disease (ASCVD) and mortality according to DKD stages. DKD was defined as albuminuria or low estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² in patients with diabetes mellitus.
Results
The prevalence of DKD was 25.4% (albuminuria, 22.0%; low eGFR, 6.73%) in patients with diabetes mellitus aged ≥30 years. Patients with DKD had a higher rate of comorbidities, including hypertension, dyslipidemia, and central obesity; however, their control rates were lower than those without DKD. Prescription rate of SGLT2 inhibitors with reduced eGFR increased steadily, reaching 5.94% in 2019. Approximately 70% of DKD patients were treated with RAS blockers. The prevalence rate of diabetesrelated ESKD has been steadily increasing, with a higher rate in older adults. ASCVD and mortality were significantly associated with an in increase in DKD stage.
Conclusion
DKD is prevalent among Korean patients with diabetes and is an independent risk factor for cardiovascular morbidity and mortality, which requiring intensive management of diabetes and comorbidities. The prevalence of diabetes-related ESKD has been increasing, especially in the older adults, during past decade.

Citations

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THE STATE OF CARBOHYDRATE METABOLISM AND RENAL FUNCTION IN PATIENTS WITH ACUTE CORONARY SYNDROME. LITERATURE REVIEW
S.U. Kazaryan, R.B. Bazarbekova, A.K. Dosanova, R.A. Kasymalieva, Zh.A. Nurlykaimova, K.S. Absatarova, M.M. Yakubova
Наука и здравоохранение.2026; (6(27)): 172. CrossRef
Nationwide Big Data Studies of Endocrine Diseases Using the Korean National Health Information Database: Research Trends and Standardization of Operational Definitions
Sun Wook Cho, Jung Hee Kim, Kyoung Jin Kim, Beom-Jun Kim, Mee Kyoung Kim, Eun Jung Rhee
Endocrinology and Metabolism.2026; 41(1): 86. 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
Xaliproden improves diabetic kidney disease through JNK-mediated renal tubular protection
Hsin-Jou Lee, Chih-Hung Chiang, Szu-Chi Kuo, Chen-Wei Chu, Su-Chu Lin, Ting-Ting Chang
Biochemical Pharmacology.2026; 249: 117923. CrossRef
Cardiorenal outcomes of empagliflozin versus dapagliflozin in primary prevention among patients with type 2 diabetes: A nationwide cohort study
Sangwoo Park, Jooyi Jung, Joonho Jeong, Mi Hee Jang, Yong-Giun Kim, Soe Hee Ann, Shin-Jae Kim, Seungbong Han, Gyung-Min Park
Diabetes Research and Clinical Practice.2026; 236: 113239. CrossRef
Glycemia Risk Index is Associated With Risk of Albuminuria Among Individuals With Type 1 Diabetes
Ji Yoon Kim, Jee Hee Yoo, Nam Hoon Kim, Jae Hyeon Kim
Journal of Diabetes Science and Technology.2025;[Epub] CrossRef
Big Data Research for Diabetes-Related Diseases Using the Korean National Health Information Database
Kyung-Soo Kim, Bongseong Kim, Kyungdo Han
Diabetes & Metabolism Journal.2025; 49(1): 13. CrossRef
Effect of Glomerular Hyperfiltration on Incident Cardiovascular Disease in Patients with Type 2 Diabetes Mellitus
Seung Min Chung, Inha Jung, Da Young Lee, So Young Park, Ji Hee Yu, Jun Sung Moon, Ji A. Seo, Kyung-Do Han, Nan Hee Kim
Clinical Journal of the American Society of Nephrology.2025; 20(3): 410. CrossRef
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A Machine Learning-Based Prediction Model for Diabetic Kidney Disease in Korean Patients with Type 2 Diabetes Mellitus
Kyung Ae Lee, Jong Seung Kim, Yu Ji Kim, In Sun Goak, Heung Yong Jin, Seungyong Park, Hyejin Kang, Tae Sun Park
Journal of Clinical Medicine.2025; 14(6): 2065. CrossRef
Optimal Management of Diabetic Kidney Disease
Jae-Han Jeon
The Journal of Korean Diabetes.2025; 26(1): 1. CrossRef
Association Between Healthy Dietary Patterns and Chronic Kidney Disease in Patients with Diabetes: Findings from Korean National Health and Nutrition Examination Survey 2019–2021
Minsang Kim, Jung Koh, Jeong Cho, Semin Cho, Soojin Lee, Hyuk Huh, Seong Kim, Sehyun Jung, Eunjeong Kang, Sehoon Park, Jin Paek, Woo Park, Kyubok Jin, Seungyeup Han, Kwon Joo, Kyungdo Han, Dong Kim, Yaerim Kim
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Jae Hyun Bae
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Mi-sook Kim, Kyu-Na Lee, Jeongmin Lee, Jeongeun Kwak, Seung-Hwan Lee, Hyuk-Sang Kwon, Jing Hughes, Kyung-Do Han, Eun Young Lee
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Kyunghun Sung, Jae-Seung Yun, Bongseong Kim, Hun-Sung Kim, Jae-Hyoung Cho, Yong-Moon Mark Park, Kyungdo Han, Seung-Hwan Lee
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Chiwook Chung, Kyu Na Lee, Kyungdo Han, Junhee Park, Dong Wook Shin, Sei Won Lee
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Kyungdo Han, Jin-Hyung Jung, Sang-Suk Choi, Seung-Hyun Ko
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Yujiang Zhang, Qin Deng, Jianping Yi
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Ji Yoon Kim, Seohyun Kim, Jae Hyeon Kim
Diabetes & Metabolism Journal.2025; 49(5): 1040. CrossRef
Burden of End-Stage Kidney Disease by Type 2 Diabetes Mellitus Status in South Korea: A Nationwide Epidemiologic Study (Diabetes Metab J 2025;49:498-506)
Ji Eun Jun
Diabetes & Metabolism Journal.2025; 49(5): 1137. CrossRef
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Han Na Jung, Ji Hye Heo, Myung Jin Kim, Kyung-Do Han, Jun Goo Kang, Seong Jin Lee
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Ji Hong You, Kang Ju Son, Kyoung Sook Park, Byung-Wan Lee, Sun Ok Song
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Metabolic Risk/Epidemiology
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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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
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Asmaa AbdelFattah, Mahmoud Kattab, Hosny Abdel Ghany, Lamiaa Aly, Ahmed Mady, Aly Hamdi, Riham Soliman, Gamal Shiha, Nada El-Domiaty
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Can Huang, Meng Chen, Yanfang Sun, Lin Zhang, Wei Liu
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Tianzhu Chen, Xiang Qin, Jianping Jiang, Beihui He
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Tatjana Ábel, Béla Benczúr, Éva Csajbókné Csobod
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Complications
The Risk of Shoulder Adhesive Capsulitis in Individuals with Prediabetes and Type 2 Diabetes Mellitus: A Longitudinal Nationwide Population-Based Study: Jong-Ho Kim, Bong-Seoung Kim, Kyung-do Han, Hyuk-Sang Kwon; Diabetes Metab J. 2023;47(6):869-878. Published online August 23, 2023; DOI: https://doi.org/10.4093/dmj.2022.0275

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Background
This study aimed to investigate the association between type 2 diabetes mellitus (T2DM) and shoulder adhesive capsulitis (AC) using a large-scale, nationwide, population-based cohort in the Republic of Korea.
Methods
A total of 3,471,745 subjects aged over 20 years who underwent a National Health Insurance Service medical checkup between 2009 and 2010 were included in this study, and followed from the date of their medical checkup to the end of 2018. Subjects were classified into the following four groups based on the presence of dysglycemia and history of diabetes medication: normal, prediabetes, newly diagnosed T2DM (new-T2DM), and T2DM (claim history for antidiabetic medication). The endpoint was new-onset AC during follow-up. The incidence rates (IRs) in 1,000 person-years and hazard ratios (HRs) of AC for each group were analyzed using Cox proportional hazard regression models.
Results
The IRs of AC were 9.453 (normal), 11.912 (prediabetes), 14.933 (new-T2DM), and 24.3761 (T2DM). The adjusted HRs of AC in the prediabetes, new-T2DM, and T2DM groups were 1.084 (95% confidence interval [CI], 1.075 to 1.094), 1.312 (95% CI, 1.287 to 1.337), and 1.473 (95% CI, 1.452 to 1.494) compared to the normal group, respectively. This secular trend of the HRs of AC according to T2DM status was statistically significant (P<0.0001).
Conclusion
This large-scale, longitudinal, nationwide, population-based cohort study of 3,471,745 subjects confirmed that the risk of AC increases in prediabetic subjects and is associated with T2DM status.

Citations

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The Association Between Type 2 Diabetes Mellitus and Frozen Shoulder: Expert Insights on Developing a Screening Tool
Anirban Majumdar, Voleti S. Nagesh, Rakesh K. Sahay, Nilanjan Sengupta, Debmalya Sanyal, Griddaluru V. Chanukya, Rana Bhattacharjee, Amit Goel, Raman Boddula, Sudhakar R. Pendyala, Amitabh Sur
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Complications
Association of Body Mass Index and Fracture Risk Varied by Affected Bones in Patients with Diabetes: A Nationwide Cohort Study: Se-Won Lee, Kyungdo Han, Hyuk-Sang Kwon; Diabetes Metab J. 2023;47(2):242-254. Published online January 19, 2023; DOI: https://doi.org/10.4093/dmj.2022.0001

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Background
Body mass index (BMI) is a risk factor for the type 2 diabetes (T2DM), and T2DM accompanies various complications, such as fractures. We investigated the effects of BMI and T2DM on fracture risk and analyzed whether the association varied with fracture locations.
Methods
This study is a nationwide population-based cohort study that included all people with T2DM (n=2,746,078) who received the National Screening Program during 2009–2012. According to the anatomical location of the fracture, the incidence rate and hazard ratio (HR) were analyzed by dividing it into four categories: vertebra, hip, limbs, and total fracture.
Results
The total fracture had higher HR in the underweight group (HR, 1.268; 95% CI, 1.228 to 1.309) and lower HR in the obese group (HR, 0.891; 95% CI, 0.882 to 0.901) and the morbidly obese group (HR, 0.873; 95% CI, 0.857 to 0.89), compared to reference (normal BMI group). Similar trends were observed for HR of vertebra fracture. The risk of hip fracture was most prominent, the risk of hip fracture increased in the underweight group (HR, 1.896; 95% CI, 1.178 to 2.021) and decreased in the obesity (HR, 0.643; 95% CI, 0.624 to 0.663) and morbidly obesity group (HR, 0.627; 95% CI, 0.591 to 0.665). Lastly, fracture risk was least affected by BMI for limbs.
Conclusion
In T2DM patients, underweight tends to increase fracture risk, and overweight tends to lower fracture risk, but association between BMI and fracture risk varied depending on the affected bone lesions.

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Review

Metabolic Risk/Epidemiology
Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications: Joon Ho Moon, Hak Chul Jang; Diabetes Metab J. 2022;46(1):3-14. Published online January 27, 2022; DOI: https://doi.org/10.4093/dmj.2021.0335

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Gestational diabetes mellitus (GDM) is the most common complication during pregnancy and is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. GDM is associated with adverse pregnancy outcomes and long-term offspring and maternal complications. For GDM screening and diagnosis, a two-step approach (1-hour 50 g glucose challenge test followed by 3-hour 100 g oral glucose tolerance test) has been widely used. After the Hyperglycemia and Adverse Pregnancy Outcome study implemented a 75 g oral glucose tolerance test in all pregnant women, a one-step approach was recommended as an option for the diagnosis of GDM after 2010. The one-step approach has more than doubled the incidence of GDM, but its clinical benefit in reducing adverse pregnancy outcomes remains controversial. Long-term complications of mothers with GDM include type 2 diabetes mellitus and cardiovascular disease, and complications of their offspring include childhood obesity and glucose intolerance. The diagnostic criteria of GDM should properly classify women at risk for adverse pregnancy outcomes and long-term complications. The present review summarizes the strengths and weaknesses of the one-step and two-step approaches for the diagnosis of GDM based on recent randomized controlled trials and observational studies. We also describe the long-term maternal and offspring complications of GDM.

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Brief Report

Metabolic Risk/Epidemiology
Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study: Hyun Ho Choi, Giwoong Choi, Hojun Yoon, Kyoung Hwa Ha, Dae Jung Kim; Diabetes Metab J. 2022;46(5):803-807. Published online January 11, 2022; DOI: https://doi.org/10.4093/dmj.2021.0236

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We investigated the incidence of diagnosed diabetes in South Korean adults (aged ≥20 years) by analyzing data for the National Health Insurance Service–National Sample Cohort. From 2006 to 2015, the overall incidence rate of diagnosed diabetes decreased by approximately 0.1% per year until 2015. Although, this trend was observed in individuals aged 40 years or over, the rate increased slightly in the 20–29 and 30–39 years age groups, from 0.5 to 0.7 and 2.0 to 2.6 per 1,000 individuals, respectively. The proportion of obese young adults with diabetes increased remarkably, from 51.4% in 2006 to 72.4% in 2015. Thus, young adults need early identification and weight-control strategies to prevent diabetes.

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Original Articles

Complications
High Incidence of Chronic Kidney Disease among Iranian Diabetic Adults: Using CKD-EPI and MDRD Equations for Estimated Glomerular Filtration Rate: Seyyed Saeed Moazzeni, Reyhane Hizomi Arani, Mitra Hasheminia, Maryam Tohidi, Fereidoun Azizi, Farzad Hadaegh; Diabetes Metab J. 2021;45(5):684-697. Published online March 16, 2021; DOI: https://doi.org/10.4093/dmj.2020.0109

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Background
To investigate the population based incidence rate of chronic kidney disease (CKD) and its potential risk factors among Iranian diabetic adults during over 14 years of follow-up.
Methods
Two different equations (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] and Modification of Diet in Renal Disease [MDRD]) were applied for the calculating the estimated glomerular filtration rate (eGFR). Among a total of 1,374 diabetic Tehranian adults, 797 and 680 individuals were eligible for CKD-EPI and MDRD analyses, respectively. CKD was defined as eGFR lower than 60 mL/min/1.73 m². Multivariable Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CI) for all potential risk factors.
Results
The incidence rates (95% CI) of CKD per 1,000 person-years were 43.84 (39.49 to 48.66) and 55.80 (50.29 to 61.91) based on CKD-EPI and MDRD equations, respectively. Being older, a history of cardiovascular disease, and having lower levels of eGFR were significant risk factors in both equations. Moreover, in CKD-EPI, using glucose-lowering medications and hypertension, and in MDRD, female sex and fasting plasma glucose ≥10 mmol/L were also independent risk factors. Regarding the discrimination index, CKD-EPI equation showed a higher range of C-index for the predicted probability of incident CKD in the full-adjusted model, compared to MDRD equation (0.75 [0.72 to 0.77] vs. 0.69 [0.66 to 0.72]).
Conclusion
We found an incidence rate of more than 4%/year for CKD development among our Iranian diabetic population. Compared to MDRD, it can be suggested that CKD-EPI equation can be a better choice to use for prediction models of incident CKD among the Iranian diabetic populations.

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COVID-19
Does Diabetes Increase the Risk of Contracting COVID-19? A Population-Based Study in Korea: Sung-Youn Chun, Dong Wook Kim, Sang Ah Lee, Su Jung Lee, Jung Hyun Chang, Yoon Jung Choi, Seong Woo Kim, Sun Ok Song; Diabetes Metab J. 2020;44(6):897-907. Published online December 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0199

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Background
This study aimed to determine the infection risk of coronavirus disease 2019 (COVID-19) in patients with diabetes (according to treatment method).
Methods
Claimed subjects to the Korean National Health Insurance claims database diagnosed with COVID-19 were included. Ten thousand sixty-nine patients with COVID-19 between January 28 and April 5, 2020, were included. Stratified random sampling of 1:5 was used to select the control group of COVID-19 patients. In total 50,587 subjects were selected as the control group. After deleting the missing values, 60,656 subjects were included.
Results
Adjusted odds ratio (OR) indicated that diabetic insulin users had a higher risk of COVID-19 than subjects without diabetes (OR, 1.25; 95% confidence interval [CI], 1.03 to 1.53; P=0.0278). In the subgroup analysis, infection risk was higher among diabetes male insulin users (OR, 1.42; 95% CI, 1.07 to 1.89), those between 40 and 59 years (OR, 1.66; 95% CI, 1.13 to 2.44). The infection risk was higher in diabetic insulin users with 2 to 4 years of morbidity (OR, 1.744; 95% CI, 1.003 to 3.044).
Conclusion
Some diabetic patients with certain conditions would be associated with a higher risk of acquiring COVID-19, highlighting their need for special attention. Efforts are warranted to ensure that diabetic patients have minimal exposure to the virus. It is important to establish proactive care and screening tests for diabetic patients suspected with COVID-19 for timely disease diagnosis and management.

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Brief Report

Complications
Trends in the Incidence, Prevalence, and Mortality of End-Stage Kidney Disease in South Korea: Min-Jeong Lee, Kyoung Hwa Ha, Dae Jung Kim, Inwhee Park; Diabetes Metab J. 2020;44(6):933-937. Published online December 23, 2020; DOI: https://doi.org/10.4093/dmj.2020.0156

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Knowledge of the epidemiologic characteristics of end-stage kidney disease (ESKD) patients is essential. The trends in the prevalence, incidence, and mortality rates of ESKD were analyzed retrospectively using the Korean National Health Insurance ServiceNational Sample Cohort database between 2006 and 2015. From 2006 to 2015, the incidence of ESKD decreased from 28.6 to 24.0 per 100,000 people and showed a decreasing pattern with or without diabetes mellitus. However, the incidence of those aged ≥75 years increased, as did the mean age at the onset of ESKD. From 2007 to 2015, the prevalence of ESKD increased in all age groups, but particularly in those aged ≥75 years. The prevalence of ESKD differed by sex and diabetes mellitus status and this gap widened over time. Mortality rates in ESKD patients remained relatively constant throughout the study period. However, mortality rates in ESKD without diabetes decreased over the same period.

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Original Articles

Type 1 Diabetes
Incidence and Prevalence of Type 1 Diabetes Mellitus among Korean Children and Adolescents between 2007 and 2017: An Epidemiologic Study Based on a National Database: Hyun Wook Chae, Gi Hyeon Seo, Kyungchul Song, Han Saem Choi, Junghwan Suh, Ahreum Kwon, Sangmi Ha, Ho-Seong Kim; Diabetes Metab J. 2020;44(6):866-874. Published online November 4, 2020; DOI: https://doi.org/10.4093/dmj.2020.0212

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Background
The incidence of type 1 diabetes mellitus (T1DM) among children is high in Europe and the USA and relatively low in Asia, including Korea. The present study aimed to investigate the incidence and prevalence of childhood-onset T1DM in Korea and examine trends in incidence.
Methods
This study was conducted using the national registry data provided by the Health Insurance Review and Assessment Service in Korea from 2007 to 2017. We included children aged 0 to 14 years who were newly registered with a T1DM diagnosis each year (code E10).
Results
A total of 29,013 children were registered. The overall incidence of T1DM was 4.45 per 100,000 persons (girls, 4.93; boys, 4.01). The overall incidence of childhood-onset T1DM in Korea increased from 3.70 in 2008 to 4.77 in 2016 (P=0.002). The incidence of T1DM increased from 3.07 in 2008 to 4.89 in 2016 (P<0.001) among boys. Although the incidence of the disease increased significantly among boys aged 5–9 and 10–14 years, it remained constant among girls (4.39 in 2008, 4.64 in 2016). The overall prevalence of childhood-onset T1DM in Korea increased from 32.85 in 2007 to 41.03 per 100,000 persons in 2017 (girls, 35.54 to 43.88; boys, 32.85 to 41.03).
Conclusion
We calculated relatively accurate incidence and prevalence of childhood-onset T1DM from a nation-based registry. The incidence increased by 3% to 4% every year from 2007 to 2017. The increasing trend is noteworthy compared with previous reports.

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Epidemiology
High Proportion of Adult Cases and Prevalence of Metabolic Syndrome in Type 1 Diabetes Mellitus Population in Korea: A Nationwide Study: You-Bin Lee, Kyungdo Han, Bongsung Kim, Sang-Man Jin, Seung-Eun Lee, Ji Eun Jun, Jiyeon Ahn, Gyuri Kim, Jae Hyeon Kim; Diabetes Metab J. 2019;43(1):76-89. Published online August 22, 2018; DOI: https://doi.org/10.4093/dmj.2018.0048

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Background

The prevalence and incidence of type 1 diabetes mellitus (T1DM) in all age groups and the prevalence of metabolic syndrome in patients with T1DM in Korea were estimated.

Methods

The incidence and prevalence of T1DM between 2007 and 2013 were calculated using the Korean National Health Insurance Service (NHIS) datasets of claims. Clinical characteristics and prevalence of metabolic syndrome in individuals with T1DM between 2009 and 2013 were determined using the database of NHIS preventive health checkups.

Results

The prevalence of T1DM in Korea between 2007 and 2013 was 0.041% to 0.047%. The annual incidence rate of T1DM in Korea in 2007 to 2013 was 2.73 to 5.02/100,000 people. Although the incidence rate of typical T1DM was highest in teenagers, it remained steady in adults over 30 years of age. In contrast, the incidence rate of atypical T1DM in 2013 was higher in people aged 40 years or older than in younger age groups. Age- and sex-adjusted prevalence of metabolic syndrome in patients with T1DM was 51.65% to 55.06% between 2009 and 2013.

Conclusion

T1DM may be more common in Korean adults than previously believed. Metabolic syndrome may be a frequent finding in individuals with T1DM in Korea.

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Epidemiology of Type 1 Diabetes Mellitus in Korea through an Investigation of the National Registration Project of Type 1 Diabetes for the Reimbursement of Glucometer Strips with Additional Analyses Using Claims Data: Sun Ok Song, Young Duk Song, Joo Young Nam, Kyeong Hye Park, Ji-Hae Yoon, Kyung-Mi Son, Young Ko, Dong-Ha Lim; Diabetes Metab J. 2016;40(1):35-45. Published online December 1, 2015; DOI: https://doi.org/10.4093/dmj.2016.40.1.35

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Background

The aim of this study was to estimate the prevalence and incidence of type 1 diabetes mellitus (T1DM) in Korea. In addition, we planned to do a performance analysis of the Registration Project of Type 1 diabetes for the reimbursement of consumable materials.

Methods

To obtain nationwide data on the incidence and prevalence of T1DM, we extracted claims data from July 2011 to August 2013 from the Registration Project of Type 1 diabetes on the reimbursement of consumable materials in the National Health Insurance (NHI) Database. For a more detailed analysis of the T1DM population in Korea, stratification by gender, age, and area was performed, and prevalence and incidence were calculated.

Results

Of the 8,256 subjects enrolled over the 26 months, the male to female ratio was 1 to 1.12, the median age was 37.1 years, and an average of 136 new T1DM patients were registered to the T1DM registry each month, resulting in 1,632 newly diagnosed T1DM patients each year. We found that the incidence rate of new T1DM cases was 3.28 per 100,000 people. The average proportion of T1DM patients compared with each region's population was 0.0125%. The total number of insurance subscribers under the universal compulsory NHI in Korea was 49,662,097, and the total number of diabetes patients, excluding duplication, was 3,762,332.

Conclusion

The prevalence of T1DM over the course of the study was approximately 0.017% to 0.021% of the entire population of Korea, and the annual incidence of T1DM was 3.28:100,000 overall and 3.25:100,000 for Koreans under 20 years old.

Citations

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The Epidemiology of Diabetes in Korea: Dae Jung Kim; Diabetes Metab J. 2011;35(4):303-308. Published online August 31, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.4.303

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Diabetes is an increasing global health problem worldwide. Diabetes and its complications have become a major cause of morbidity and mortality in Korea. The prevalence of diabetes in Korea has increased six- to seven-fold from 1.5% to 9.9% in the past 40 years. The prevalence of impaired fasting glucose also increased to about 20% in 2009. The International Diabetes Federation has estimated that the prevalence of diabetes will rise to 11.4% in 2030. Possible risk factors for diabetes in Korea are age, male gender, obesity, prediabetes, gestational diabetes, smoking, decreased physical activity, and short sleep duration. With increasing obesity, especially in childhood, and improved longevity, the prevalence of diabetes is expected to dramatically increase more than previously estimated. Therefore, public efforts to introduce healthy lifestyle changes and diabetic prevention programs are necessary to reduce the global epidemic of diabetes.

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Gestational Diabetes in Korea: Incidence and Risk Factors of Diabetes in Women with Previous Gestational Diabetes: Hak Chul Jang; Diabetes Metab J. 2011;35(1):1-7. Published online February 28, 2011; DOI: https://doi.org/10.4093/dmj.2011.35.1.1

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Korean women with a history of gestational diabetes mellitus (GDM) have a 3.5 times greater risk of developing postpartum diabetes than the general population. The incidence of type 2 diabetes mellitus in early postpartum is reported as 10-15% in Korean women. A prospective follow-up study on Korean women with GDM showed that approximately 40% of women with previous GDM were expected to develop diabetes within 5 years postpartum. Independent risk factors for the development of diabetes in Korean women with previous GDM are pre-pregnancy body weight, gestational age at diagnosis, antepartum hyperglycemia on oral glucose tolerance test, low insulin response to oral glucose load, and family history of diabetes. Women with postpartum diabetes have greater body mass indexes, body weight, and waist circumferences than women with normal glucose tolerance. Multiple logistic regression analysis has revealed that waist circumference is the strongest obesity index along with systolic blood pressure and that triglyceride levels are a major independent risk factor for developing diabetes. These results in Korean women with previous GDM underline the importance of postpartum testing in Korean women diagnosed with GDM, and demonstrate that impaired B-cell function, obesity, and especially visceral obesity, are associated with the development of diabetes.

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Original Articles

Current Status of Diabetic Foot in Korean Patients Using National Health Insurance Database.: Choon Hee Chung, Dae Jung Kim, Jaiyong Kim, Hyeyoung Kim, Hwayoung Kim, Kyung Wan Min, Seok Won Park, Jeong Hyun Park, Sei Hyun Baik, Hyun Shik Son, Chul Woo Ahn, Jee Young Oh, Sunhee Lee, Juneyoung Lee, Kyung Mook Choi, Injeoung Choi, Ie Byung Park; Korean Diabetes J. 2006;30(5):372-376. Published online September 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.5.372

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Abstract PDF

BACKGROUND
Foot ulcer diseases are more prevalent in diabetic patients than that those of non-diabetic patients. Several reports showed the risk of amputation and the medical cost were increased when foot ulcer developed. Therefore, strict glycemic control from the initial period of diabetes is necessary. Since there is no enough epidemiologic data, large scaled studies for medical and economic consequences about diabetic foot ulcer are needed. METHODS: This study was based on health insurance claims submitted to the National Health Insurance Review Agency during the period from December 1994 through December 2002. We investigated the incidence and medical cost of foot disorders in Korean population using the disease-classification codes on the health insurance claim forms. RESULTS: The incidences of foot disorders (per 100,000 of population) were 49.7 for amputations, 99.7 for ulcers, and 1,051 for injuries in diabetic patients, and 4.2 for amputations, 10.3 for ulcers, and 943 for injuries in non-diabetic patients. Relative risk of the incidences of foot amputation, ulcer, and injury in diabetic patients comparing with non-diabetic patients were 11.7, 9.7, and 1.1, respectively. Total medical costs (per capita) of foot amputation, ulcer, and injury in diabetic patients were 2.0, 1.7, and 2.1 times higher, respectively, than those of non-diabetic patients. Mean hospital stay of foot amputation, ulcer, and injury in diabetic patients were 1.6, 1.3, and 1.7 times more, respectively, than those of non-diabetic patients. CONCLUSION: In diabetic patients, the incidences of foot amputation and ulcer are higher than those of non-diabetic patients. To reduce those incidences, we need to early strict glycemic control as well as government based management.

Citations

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The Risk of the Aggravation of Diabetic Foot According to Air Quality Factors in the Republic of Korea: A Nationwide Population-Based Study
Saintpee Kim, Sungho Won, Young Yi
International Journal of Environmental Research and Public Health.2024; 21(6): 775. CrossRef
Efficacy of a povidone‐iodine foam dressing (Betafoam) on diabetic foot ulcer
Heui C. Gwak, Seung H. Han, Jinwoo Lee, Sejin Park, Ki‐Sun Sung, Hak‐Jun Kim, Dongil Chun, Kyungmin Lee, Jae‐Hoon Ahn, Kyunghee Kwak, Hyung‐Jin Chung
International Wound Journal.2020; 17(1): 91. CrossRef
Regional Variation in the Incidence of Diabetes-Related Lower Limb Amputations and Its Relationship with the Regional Factors
Sung Hun Won, Jahyung Kim, Dong-Il Chun, Young Yi, Suyeon Park, Kwang-Young Jung, Gun-Hyun Park, Jaeho Cho
Journal of Korean Foot and Ankle Society.2019; 23(3): 121. CrossRef
Depth and combined infection is important predictor of lower extremity amputations in hospitalized diabetic foot ulcer patients
Eun-Gyo Jeong, Sung Shim Cho, Sang-Hoon Lee, Kang-Min Lee, Seo-Kyung Woo, Yoongoo Kang, Jae-Seung Yun, Seon-Ah Cha, Yoon-Jung Kim, Yu-Bae Ahn, Seung-Hyun Ko, Jung-Min Lee
The Korean Journal of Internal Medicine.2018; 33(5): 952. CrossRef
Risk factors for diabetic foot ulcer recurrence: A prospective 2-year follow-up study in Egypt
Walaa A. Khalifa
The Foot.2018; 35: 11. CrossRef
Microbiology and Antimicrobial Therapy for Diabetic Foot Infections
Ki Tae Kwon, David G. Armstrong
Infection & Chemotherapy.2018; 50(1): 11. CrossRef
Diagnosis and Management of Diabetic Foot
Chang Won Lee
The Journal of Korean Diabetes.2018; 19(3): 168. CrossRef
Effects of foot complications in patients with Type 2 diabetes mellitus on public healthcare: An analysis based on the Korea National Diabetes Program Cohort
So Young Park, Sang Youl Rhee, Suk Chon, Kyu Jeung Ahn, Sung-Hoon Kim, Sei Hyun Baik, Yongsoo Park, Moon Suk Nam, Kwan Woo Lee, Jeong-taek Woo, Ki Hong Chun, Young Seol Kim
Journal of Diabetes and its Complications.2017; 31(2): 375. CrossRef
Prevalence and Current Status of Treatment of Diabetic Foot in South Korea
Jae-Ik Bae, Je Hwan Won, Jun Su Kim, Man Deuk Kim, Chang Jin Yoon, Yun Ku Cho
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Lifestyle, Diet, Self-care, and Diabetes Fatalism of Diabetic Patients with and without Diabetic Foot
Jungha Choi, Juhee Kang, Hongmie Lee
Korean Journal of Community Nutrition.2014; 19(3): 241. CrossRef
The Quality of Medical Care Provided to Homeless Diabetes Patients in a General Hospital in Seoul, and the Prevalence of Diabetes Comorbidities
Sun Hee Beom, Moo Kyung Oh, Chul Woo Ahn
Korean Journal of Medicine.2014; 86(5): 585. CrossRef
Advanced Glycation End Products and Management of Diabetes Diet
Hyun-Sun Lee
The Journal of Korean Diabetes.2013; 14(2): 90. CrossRef
Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot
Chong Rye Song, Yong Soon Kim, Jin Hyun Kim
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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 & Metabolism Journal.2013; 37(4): 233. CrossRef
Treatment of Diabetic Foot Ulcer Using Matriderm In Comparison with a Skin Graft
Hyojin Jeon, Junhyung Kim, Hyeonjung Yeo, Hoijoon Jeong, Daegu Son, Kihwan Han
Archives of Plastic Surgery.2013; 40(04): 403. CrossRef
Three Cases of Auricular Pressure Ulcer in Ambulatory Leprotic Patients
Nam Soo Han, Hyung-Cheol Park
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Ji Ho Lee, Choon Hee Chung
Journal of Korean Diabetes.2011; 12(2): 69. CrossRef
Epidemiology of Diabetic Foot Disease
Kyu Jeung Ahn
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Current Status of Diabetic End-Stage Renal Disease Using Korean Health Insurance Database.: Dae Jung Kim, Jaiyong Kim, Hyeyoung 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, Hwayoung Kim; Korean Diabetes J. 2006;30(5):355-362. Published online September 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.5.355

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Abstract PDF

BACKGROUND
Diabetes is becoming one of the main causes of end-stage renal disease (ESRD) worldwide. We studied the prevalence and incidence of end-stage renal disease (ESRD) in the Korean population based on health insurance claims submitted to the Health Insurance Review Agency. We also investigated the proportion of medications taken by the ESRD patients, and frequency of hospital admission or visits, and medical expenses between ESRD patients with and without diabetes. METHODS: This study was based on health insurance claims submitted to the Health Insurance Review Agency during the period from January 2001 through December 2003. Using the disease-classification codes on the health insurance claim forms, those who were diagnosed with chronic renal disease (N18 or N19) and received dialysis-related treatment (Z49), treatment with a kidney dialysis machine (Z99.2), or kidney transplantation (Z94.0) were defined as ESRD patients. Among the ESRD patients, those who were diagnosed with diabetes (E10-E14) and/or took anti-diabetic drugs were defined as ESRD patients with diabetes. RESULTS: The ESRD patients totaled 33,870 in 2001, 37,894 in 2002, and 41,167 (858.3 per million population) in 2003. ESRD patients with diabetes increased to 56.7% in 2003. The number of ESRD patients in whom renal replacement therapy was initiated was 8,134 in 2002 and 8,322 (173.5 per million population) in 2003. ESRD patients with diabetes used more anti-hypertensive drugs (1.2 times as many), lipid-lowering drugs (1.6 times), and anti-platelet agents (1.8 times) than did ESRD patients without diabetes. In 2003, 66.5% of the ESRD patients with diabetes were hospitalized, which was 1.6 times the hospital admissions of ESRD patients without diabetes. ESRD patients with diabetes also had hospital stays that were 1.6 times longer per patient and inpatient service expenses that were 1.6times greater per patient, compared with those reported for ESRD patients without diabetes. CONCLUSION: The incidence of ESRD accompanied by diabetes has risen rapidly. Given the burden of medical treatment costs placed on ESRD patients with diabetes, more aggressive interventions should be implemented to prevent diabetes and renal complications among patients with diabetes.

Citations

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Health-Related Quality of Life Based on Comorbidities Among Patients with End-Stage Renal Disease
Jieun Cha, Dallong Han
Osong Public Health and Research Perspectives.2020; 11(4): 194. CrossRef
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Hwa Jeong Seo
Journal of Health Informatics and Statistics.2020; 45(4): 356. CrossRef
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Jieun Cha
Journal of Health Informatics and Statistics.2018; 43(3): 159. CrossRef
Effect of diabetic case management intervention on health service utilization in Korea
Soon Ae Shin, Hyeongsu Kim, Kunsei Lee, Vivian Lin, George Liu
International Journal of Nursing Practice.2015; 21(6): 780. CrossRef
The Quality of Medical Care Provided to Homeless Diabetes Patients in a General Hospital in Seoul, and the Prevalence of Diabetes Comorbidities
Sun Hee Beom, Moo Kyung Oh, Chul Woo Ahn
Korean Journal of Medicine.2014; 86(5): 585. CrossRef
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 & Metabolism Journal.2013; 37(4): 233. CrossRef
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Hye Soo Kim, Suk Young Kim
Korean Journal of Transplantation.2009; 23(2): 123. CrossRef

The Prevalence and Incidence of Diabetes in Mokdong, Seoul.: Jee Young Oh, Hye Jin Lee, Eun Soon Hong, Young Sun Hong, Yeon Ah Sung, Sun Hee Lee; Korean Diabetes J. 2003;27(1):73-83. Published online February 1, 2003

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Abstract PDF: BACKGROUND
Diabetes has recently become a major public health problem due to the socioeconomic changes in Korea. Epidemiological data for diabetes are needed to establish disease control and health improvement programs in the community. Considering the tendency for larger concentrations of the population in the urban areas of Korea, epidemiological studies in these areas are essential. This this was performed to determine the epidemiologic characteristics, prevalence, and incidence of diabetes in Korean urban communities. METHODS: The target cohort of this study was randomly selected from 20,222 residents living in the Mokdong apartment areas one, two, five and six, Yangcheon-Gu, Seoul. Of the 20,222 residents, 1,011 were residents, of which 766 (male 264, female 502) subjects participated and 372 subjects without diabetes at baseline examination followed up for 2 years. At the baseline and follow-up examination, all subjects underwent a 75g oral glucose tolerance test (OGTT) and anthropometric measurements (height, weight, waist to hip ratio, pulse rate, blood pressure, and subcutaneous skin fold thickness) were performed. RESULTS: There was an 8.5% prevalence of diabetes and 7.8% with impaired glucose regulation (IGR), including impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). The age-adjusted prevalence of diabetes IGR were 8.4% and 7.1%, respectively. The prevalence of diabetes or IGR increased with increasing age. The prevalence of diabetes was associated with aging, family history of diabetes, and high levels of waist to hip ratio. The age-adjusted annual incidence rate of diabetes for subjects over 40 years of age at the baseline was 1.3%. The risk factors for the development of incident diabetes, from a multiple logistic regression analysis, were the waist to hip ratio and the 2-hour postload serum glucose concentrations. CONCLUSION: The prevalence of diabetes in the Mokdong apartment area was slightly higher than in Yonchon, Jungup, or Beijing. The annual incidence of diabetes was lower than that found in the studies in Yonchon or in Pima Indian, but higher than those of Caucasians or American Hispanics.

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