Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
권호 표지
DOI QR코드

DOI QR Code

Current Status of Glycemic Control of Patients with Diabetes in Korea: The Fifth Korea National Health and Nutrition Examination Survey

  • Jeon, Ja Young (Department of Endocrinology and Metabolism, Ajou University School of Medicine) ;
  • Kim, Dae Jung (Department of Endocrinology and Metabolism, Ajou University School of Medicine) ;
  • Ko, Seung-Hyun (Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kwon, Hyuk-Sang (Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lim, Soo (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Choi, Sung Hee (Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Kim, Chul Sik (Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • An, Jee Hyun (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Nan Hee (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine) ;
  • Won, Jong Chul (Department of Internal Medicine, Mitochondrial Research Group, Inje University Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Jae Hyeon (Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cha, Bong-Yun (Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Song, Kee-Ho (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association (Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association)
  • Received : 2014.03.20
  • Accepted : 2014.04.08
  • Published : 2014.06.17
⟨ Previous Next ⟩

Abstract

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 ${\geq}30$ 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 ${\leq}5$ 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.

Keywords

References

  1. Statistics Korea: Causes of death statistics 2012. Available from: http://kostat.go.kr (updated 2013 Sep 25).
  2. Nolan CJ, Damm P, Prentki M. Type 2 diabetes across generations: from pathophysiology to prevention and management. Lancet 2011;378:169-81. https://doi.org/10.1016/S0140-6736(11)60614-4
  3. Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA 2002;287:2570-81. https://doi.org/10.1001/jama.287.19.2570
  4. Jeon JY, Ko SH, Kwon HS, Kim NH, Kim JH, Kim CS, Song KH, Won JC, Lim S, Choi SH, Jang MJ, Kim Y, Oh K, Kim DJ, Cha BY; Taskforce Team of Diabetes Fact Sheet of the Korean Diabetes Association. Prevalence of diabetes and prediabetes according to fasting plasma glucose and HbA1c. Diabetes Metab J 2013;37:349-57. https://doi.org/10.4093/dmj.2013.37.5.349
  5. Choi YJ, Kim HC, Kim HM, Park SW, Kim J, Kim DJ. Prevalence and management of diabetes in Korean adults: Korea National Health and Nutrition Examination Surveys 1998-2005. Diabetes Care 2009;32:2016-20. https://doi.org/10.2337/dc08-2228
  6. Task Force Team for Basic Statistical Study of Korean Diabetes Mellitus of Korean Diabetes Association, Park IB, Kim J, Kim DJ, Chung CH, Oh JY, Park SW, Lee J, Choi KM, Min KW, Park JH, Son HS, Ahn CW, Kim H, Lee S, Lee IB, Choi I, Baik SH. Diabetes epidemics in Korea: reappraise nationwide survey of diabetes "diabetes in Korea 2007". Diabetes Metab J 2013;37:233-9. https://doi.org/10.4093/dmj.2013.37.4.233
  7. Ali MK, Bullard KM, Saaddine JB, Cowie CC, Imperatore G, Gregg EW. Achievement of goals in U.S. diabetes care, 1999-2010. N Engl J Med 2013;368:1613-24. https://doi.org/10.1056/NEJMsa1213829
  8. Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, Sherwin R, Zinman B; Professional Practice Committee American Diabetes Association; European Association for the Study of Diabetes. Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 2006;49:1711-21. https://doi.org/10.1007/s00125-006-0316-2
  9. Yu NC, Su HY, Chiou ST, Yeh MC, Yeh SW, Tzeng MS, Sheu WH. Trends of ABC control 2006-2011: a National Survey of Diabetes Health Promotion Institutes in Taiwan. Diabetes Res Clin Pract 2013;99:112-9. https://doi.org/10.1016/j.diabres.2012.11.018
  10. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53. https://doi.org/10.1016/S0140-6736(98)07019-6
  11. Wajchenberg BL. beta-cell failure in diabetes and preservation by clinical treatment. Endocr Rev 2007;28:187-218. https://doi.org/10.1210/10.1210/er.2006-0038
  12. Walter H, Lubben G. Potential role of oral thiazolidinedione therapy in preserving beta-cell function in type 2 diabetes mellitus. Drugs 2005;65:1-13. https://doi.org/10.2165/00003495-200565010-00001
  13. Cariou B, Charbonnel B, Staels B. Thiazolidinediones and PPARgamma agonists: time for a reassessment. Trends Endocrinol Metab 2012;23:205-15. https://doi.org/10.1016/j.tem.2012.03.001
  14. Campbell JE, Drucker DJ. Pharmacology, physiology, and mechanisms of incretin hormone action. Cell Metab 2013;17:819-37. https://doi.org/10.1016/j.cmet.2013.04.008
  15. Drucker DJ, Sherman SI, Gorelick FS, Bergenstal RM, Sherwin RS, Buse JB. Incretin-based therapies for the treatment of type 2 diabetes: evaluation of the risks and benefits. Diabetes Care 2010;33:428-33. https://doi.org/10.2337/dc09-1499

Cited by

  1. It's Still Not Too Late to Make a Change: Current Status of Glycemic Control in Korea vol.38, pp.3, 2014, https://doi.org/10.4093/dmj.2014.38.3.194
  2. The Side Effects of Sodium Glucose Cotransporter 2 (SGLT2) Inhibitor vol.15, pp.3, 2014, https://doi.org/10.4093/jkd.2014.15.3.158
  3. Association between Diabetes Education Status and Clinical Outcomes of Patients with Diabetes Mellitus: Analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) vol.15, pp.4, 2014, https://doi.org/10.4093/jkd.2014.15.4.236
  4. Current status of glucose, blood pressure and lipid management in type 2 diabetes clinic attendees in Isfahan, Iran vol.6, pp.6, 2014, https://doi.org/10.1111/jdi.12349
  5. Trends in the Diabetes Epidemic in Korea vol.30, pp.2, 2014, https://doi.org/10.3803/enm.2015.30.2.142
  6. Diabetes in Asians vol.30, pp.3, 2014, https://doi.org/10.3803/enm.2015.30.3.263
  7. Insulin Initiation in Insulin-Naïve Korean Type 2 Diabetic Patients Inadequately Controlled on Oral Antidiabetic Drugs in Real-World Practice: The Modality of Insulin Treatment Evaluation Study vol.39, pp.6, 2015, https://doi.org/10.4093/dmj.2015.39.6.481
  8. Health inequalities in hypertension and diabetes management among the poor in urban areas: a population survey analysis in south Korea vol.16, pp.1, 2016, https://doi.org/10.1186/s12889-016-3169-8
  9. Association between blood glucose level derived using the oral glucose tolerance test and glycated hemoglobin level vol.31, pp.3, 2014, https://doi.org/10.3904/kjim.2015.075
  10. Current status of managing diabetes mellitus in Korea vol.31, pp.5, 2014, https://doi.org/10.3904/kjim.2016.253
  11. Reduction of Sulfonylurea with the Initiation of Basal Insulin in Patients with Inadequately Controlled Type 2 Diabetes Mellitus Undergoing Long-Term Sulfonylurea-Based Treatment vol.40, pp.6, 2014, https://doi.org/10.4093/dmj.2016.40.6.454
  12. Social Networking Services-Based Communicative Care for Patients with Diabetes Mellitus in Korea vol.7, pp.3, 2014, https://doi.org/10.4338/aci-2016-06-ra-0088
  13. 제2형 당뇨병 환자의 혈당 비조절 관련 요인분석: 국민건강영양조사(2010-2012) 자료이용 vol.26, pp.2, 2014, https://doi.org/10.4332/kjhpa.2016.26.2.125
  14. 우엉 뿌리 추출물의 최종당화산물 형성 억제 효능 vol.49, pp.4, 2016, https://doi.org/10.4163/jnh.2016.49.4.233
  15. Multi-ethnic differences in HbA 1c , blood pressure, and low-density-lipid cholesterol control among South Africans living with type 2 diabetes, after a 4-year follow-up vol.9, pp.None, 2014, https://doi.org/10.2147/ijgm.s119965
  16. Detrimental Effects of Higher Body Mass Index and Smoking Habits on Menstrual Cycles in Korean Women vol.26, pp.1, 2014, https://doi.org/10.1089/jwh.2015.5634
  17. Delay of insulin initiation in patients with type 2 diabetes mellitus inadequately controlled with oral hypoglycemic agents (analysis of patient‐ and physician‐related factors): A prospe vol.8, pp.3, 2014, https://doi.org/10.1111/jdi.12581
  18. Effectiveness of Vildagliptin in Clinical Practice: Pooled Analysis of Three Korean Observational Studies (the VICTORY Study) vol.2017, pp.None, 2014, https://doi.org/10.1155/2017/5282343
  19. Prevalence and risk factors for reduced pulmonary function in diabetic patients: The Korea National Health and Nutrition Examination Survey vol.32, pp.4, 2017, https://doi.org/10.3904/kjim.2016.045
  20. Effectiveness and safety of exenatide in Korean patients with type 2 diabetes inadequately controlled with oral hypoglycemic agents: an observational study in a real clinical practice vol.17, pp.1, 2014, https://doi.org/10.1186/s12902-017-0220-4
  21. Improved trends in cardiovascular complications among subjects with type 2 diabetes in Korea: a nationwide study (2006–2013) vol.16, pp.None, 2014, https://doi.org/10.1186/s12933-016-0482-6
  22. Negative Association of Hepatitis B Virus With Hearing Impairment vol.27, pp.3, 2018, https://doi.org/10.1044/2018_aja-17-0092
  23. Ten-Year Mortality Trends for Adults with and without Diabetes Mellitus in South Korea, 2003 to 2013 vol.42, pp.5, 2018, https://doi.org/10.4093/dmj.2017.0088
  24. Past and Current Status of Adult Type 2 Diabetes Mellitus Management in Korea: A National Health Insurance Service Database Analysis vol.42, pp.2, 2018, https://doi.org/10.4093/dmj.2018.42.2.93
  25. Women are less likely than men to achieve optimal glycemic control after 1 year of treatment: A multi-level analysis of a Korean primary care cohort vol.13, pp.5, 2014, https://doi.org/10.1371/journal.pone.0196719
  26. The effectiveness, reproducibility, and durability of tailored mobile coaching on diabetes management in policyholders: A randomized, controlled, open-label study vol.8, pp.None, 2014, https://doi.org/10.1038/s41598-018-22034-0
  27. Prediction of Type 2 Diabetes Remission after Bariatric or Metabolic Surgery vol.27, pp.4, 2018, https://doi.org/10.7570/jomes.2018.27.4.213
  28. Trends in the prevalence and management of diabetes in Korea: 2007-2017 vol.41, pp.None, 2019, https://doi.org/10.4178/epih.e2019029
  29. Current status of treatment of type 2 diabetes mellitus in Ningbo, China vol.33, pp.3, 2014, https://doi.org/10.1002/jcla.22717
  30. 성인 당뇨병 환자의 소득수준에 따른 혈당, 당화혈색소, 혈압, 및 혈중지질 지표의 변화 추이 : 국민건강영양조사 1998~2014 분석 결과 vol.52, pp.2, 2014, https://doi.org/10.4163/jnh.2019.52.2.206
  31. Factors Influencing Glycemic Control among Type 2 Diabetes Mellitus Patients: The Sixth Korea National Health and Nutrition Examination Survey (2013~2015) vol.31, pp.3, 2014, https://doi.org/10.7475/kjan.2019.31.3.235
  32. Diabetes Fact Sheets in Korea, 2018: An Appraisal of Current Status vol.43, pp.4, 2014, https://doi.org/10.4093/dmj.2019.0067
  33. Nationwide Trends in Pancreatitis and Pancreatic Cancer Risk Among Patients With Newly Diagnosed Type 2 Diabetes Receiving Dipeptidyl Peptidase 4 Inhibitors vol.42, pp.11, 2014, https://doi.org/10.2337/dc18-2195
  34. 당뇨병 관리전략을 위한 혈당조절 관련 생활습관 요인: 국민건강영양조사 활용 코호트내 환자-대조군 연구 vol.10, pp.11, 2014, https://doi.org/10.15207/jkcs.2019.10.11.501
  35. 당뇨병 환자의 비타민 D 수준이 혈당조절에 미치는 영향: 2010-2012년 국민건강영양조사 결과를 바탕으로 vol.22, pp.1, 2020, https://doi.org/10.7586/jkbns.2020.22.1.53
  36. An Assessment of Pharmacokinetic Interaction Between Lobeglitazone and Sitagliptin After Multiple Oral Administrations in Healthy Men vol.42, pp.6, 2014, https://doi.org/10.1016/j.clinthera.2020.04.005
  37. Inadequate achievement of ABC goals (HbA1c, blood pressure, LDL-C) among patients with type 2 diabetes in an Iranian population, 2012–2017 vol.14, pp.4, 2020, https://doi.org/10.1016/j.dsx.2020.05.015
  38. C-peptide level as predictor of type 2 diabetes remission and body composition changes in non-diabetic and diabetic patients after Roux-en-Y gastric bypass vol.76, pp.None, 2021, https://doi.org/10.6061/clinics/2021/e2906