Screening for Prediabetes and Diabetes in Korean Nonpregnant Adults: A Position Statement of the Korean Diabetes Association, 2022

Abstract

Diabetes screening serves to identify individuals at high-risk for diabetes who have not yet developed symptoms and to diagnose diabetes at an early stage. Globally, the prevalence of diabetes is rapidly increasing. Furthermore, obesity and/or abdominal obesity, which are major risk factors for type 2 diabetes mellitus (T2DM), are progressively increasing, particularly among young adults. Many patients with T2DM are asymptomatic and can accompany various complications at the time of diagnosis, as well as chronic complications develop as the duration of diabetes increases. Thus, proper screening and early diagnosis are essential for diabetes care. Based on reports on the changing epidemiology of diabetes and obesity in Korea, as well as growing evidence from new national cohort studies on diabetes screening, the Korean Diabetes Association has updated its clinical practice recommendations regarding T2DM screening. Diabetes screening is now recommended in adults aged ≥35 years regardless of the presence of risk factors, and in all adults (aged ≥19) with any of the risk factors. Abdominal obesity based on waist circumference (men ≥90 cm, women ≥85 cm) was added to the list of risk factors.

Keywords: Age; Diabetes mellitus, type 2; Diagnosis; Prediabetic state; Risk factors; Screening.

Fig. 1.

(A) Prevalence of diabetes and prediabetes in people aged 30 to 39 years from 2014 to 2018 and (B) prevalence of obesity and abdominal obesity in people aged 20 to 39 years from 2009 to 2019 in Korea. Obesity defined as body mass index ≥25 kg/m² and abdominal obesity defined as waist circumference ≥90 cm and ≥85 cm in men and women, respectively. DM, diabetes mellitus; IFG, impaired fasting glucose.

Fig. 2.

Number of needed to screen (NNS) to detect diabetes according to age group. Adapted from Ha et al. [22]. NHIS-NSC, National Health Insurance Service-National Sample Cohort; KNHANES, Korea National Health and Nutrition Examination Survey.