Trends in the prevalence and management of diabetes in Korea: 2007-2017

Abstract

Objectives: This study analyzed Korea National Health and Nutrition Examination Survey data from 2007 to 2017 to assess trends in the prevalence, treatment, and control of diabetes in Korean adults ≥30 years of age.

Methods: Prevalent diabetes was defined as a fasting plasma glucose level ≥126 mg/dL, self-reported use of anti-diabetic treatment (insulin or oral anti-diabetic drugs), or diabetes diagnosis by a physician. Target levels were defined as glycosylated hemoglobin <6.5% or <7.0%, blood pressure <130/80 mmHg, and total cholesterol <200 mg/dL. All survey waves were age-standardized to the 2005 Korean census population.

Results: Diabetes prevalence increased from 9.6% in 2007-2009 to 10.8% in 2016-2017 (p<0.001). Impaired fasting glucose prevalence significantly increased in both genders and almost every age group. Diabetes awareness and glycemic control did not show an increasing trend; however, the treatment rate and proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved from 57.2% to 63.5% (p=0.008), from 41.1% to 53.2% (p<0.001), and from 65.0% to 78.0% (p<0.001), respectively.

Conclusions: From 2007 to 2017, the prevalence of diabetes increased moderately in Korea, whereas the diabetes treatment rate and the proportion of people diagnosed with diabetes achieving target blood pressure and total cholesterol levels improved. However, awareness of diabetes and glycemic control require significant improvements. A national-level action plan is required to raise awareness about diabetes and prediabetes, with the goal of improving glycemic control and minimizing the occurrence of adverse health outcomes.

Keywords: Awareness; Blood pressure; Cholesterol; Diabetes mellitus; Glycated hemoglobin A; Prevalence.

Figure 1.

Weighted prevalence of impaired fasting glucose (IFG) among Korean adults aged ≥30 years according to age group and gender, 2007-2017 (A) overall, (B) men, and (C) women. ¹ Estimates were age-adjusted by direct standardization to the 2005 Korean census population. *p<0.05: p for trend values, which were derived using weighted logistic regression by including the midpoint of each survey period as a continuous variable.

Figure 2.

Age-standardized weighted proportion of diabetes awareness, treatment, and control among Korean adults with diabetes aged ≥30 years, 2007-2017 (A) awareness, (B) treatment, (C) control (A1C<6.5%) (D) control (A1C<7.0%), (E) control (BP <130/80 mmHg), and (F) control (total cholesterol <200 mg/dL). All estimates were age-standardized to the subpopulation of persons who had diabetes in the KNHANES 2005. A1C, glycosylated hemoglobin; BP, blood pressure. *p<0.05: p for trend values, which were derived using weighted logistic regression by including the midpoint of each survey period as a continuous variable.