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Practice Guideline
. 2024 Jul;48(4):546-708.
doi: 10.4093/dmj.2024.0249. Epub 2024 Jul 26.

2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association

Jun Sung Moon  1 , Shinae Kang  2 , Jong Han Choi  3 , Kyung Ae Lee  4 , Joon Ho Moon  5 , Suk Chon  6 , Dae Jung Kim  7 , Hyun Jin Kim  8 , Ji A Seo  9 , Mee Kyoung Kim  10 , Jeong Hyun Lim  11 , Yoon Ju Song  12 , Ye Seul Yang  13 , Jae Hyeon Kim  14 , You-Bin Lee  14 , Junghyun Noh  15 , Kyu Yeon Hur  14 , Jong Suk Park  2 , Sang Youl Rhee  6 , Hae Jin Kim  7 , Hyun Min Kim  16 , Jung Hae Ko  17 , Nam Hoon Kim  18 , Chong Hwa Kim  19 , Jeeyun Ahn  20 , Tae Jung Oh  5 , Soo-Kyung Kim  21 , Jaehyun Kim  22 , Eugene Han  23 , Sang-Man Jin  14 , Jaehyun Bae  24 , Eonju Jeon  25 , Ji Min Kim  26 , Seon Mee Kang  27 , Jung Hwan Park  28 , Jae-Seung Yun  29 , Bong-Soo Cha  30 , Min Kyong Moon  31 , Byung-Wan Lee  30
Affiliations
Practice Guideline

2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association

Jun Sung Moon et al. Diabetes Metab J. 2024 Jul.
No abstract available

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Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Number of people who should be screened for diabetes by age group [38]. NNS, number need to screen; NHIS-NSC, National Health Insurance Service-National Sample Cohort; KNHANES, Korea National Health and Nutrition Examination Survey.
Fig. 2.
Fig. 2.
Pharmacotherapy of type 2 diabetes mellitus algorithm. Implement and monitor diabetes self-management education immediately upon diagnosis. Prioritize treatment, including insulin, for severe symptomatic hyperglycemia. If comorbid atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), or chronic kidney disease (CKD) is present, prioritize sodium-glucose cotransporter-2 inhibitor (SGLT2i) or glucagon-like peptide-1 receptor agonist (GLP-1RA), whichever has demonstrated clinical benefit for each condition. In the absence of these conditions, metformin monotherapy is common, but other members of the class may be used based on patient condition and drug characteristics. If glycemic goals are not achieved with monotherapy, combination therapy with other classes of drugs may be considered based on drug characteristics. Patients with comorbid ASCVD, HF, or CKD who are using an SGLT2i or GLP-1RA may be added to metformin, with preference given to drugs from other classes that have demonstrated clinical benefit for each condition. Combination therapy may be initiated earlier in the course of diagnosis to reduce the risk of glycemic control failure, with early combination therapy strongly considered, especially if glycosylated hemoglobin (HbA1c) is greater than 7.5% or greater than 1.5% above target. If glycemic goals are not achieved with a combination of oral hypoglycemic agents, GLP-1RAs or basal insulin should be considered first, and a combination of GLP-1RAs or basal insulin, or insulin intensification, may be used to improve glycemic control. (1) A history of an acute coronary syndrome or myocardial infarction, stable or unstable angina, coronary heart disease with or without revascularization, other arterial revascularization, stroke, or peripheral artery disease assumed to be atherosclerotic in origin; (2) Current or prior symptoms of HF with documented HF with reduced ejection fraction (left ventricular ejection fraction [LVEF] ≤40) or HF with preserved ejection fraction (LVEF >40); (3) Estimated glomerular filtration rate <60 mL/min/1.73 m2 or urine albumin-creatinine ratio ≥30 mg/g; (4) Dulaglutide, liraglutide, semaglutide; (5) Dapagliflozin, empagliflozin; (6) Dapagliflozin, empagliflozin, ertugliflozin; (7) Pioglitazone. ASCVD, atherosclerotic cardiovascular disease; TZD, thiazolidinedione; DPP-4i, dipeptidyl peptidase-4 inhibitor; SU, sulfonylurea; α-GI, α-glucosidase inhibitors; OAD, oral antidiabetic drug.
Fig. 3.
Fig. 3.
Hypertension management. BP, blood pressure; ACE, angiotensin-converting enzyme; ARB, angiotensin II receptor blocker.
Fig. 4.
Fig. 4.
Lipid management of diabetes. LDL, low-density lipoprotein; HDL, high-density lipoprotein; CVD, cardiovascular disease; PCSK9, proprotein convertase subtilisin/kexin 9.
Fig. 5.
Fig. 5.
Follow-up and care of pregnant women with diabetes. GDM, gestational diabetes mellitus.
See this image and copyright information in PMC

References

    1. Oh JY, Lim S, Kim DJ, Kim NH, Kim DJ, Moon SD, et al. The diagnosis of diabetes mellitus in Korea: a pooled analysis of four community-based cohort studies. Diabet Med. 2007;24:217–8. - PubMed
    1. Oh JY, Lim S, Kim DJ, Kim NH, Kim DJ, Moon SD, et al. A report on the diagnosis of intermediate hyperglycemia in Korea: a pooled analysis of four community-based cohort studies. Diabetes Res Clin Pract. 2008;80:463–8. - PubMed
    1. American Diabetes Association Standards of medical care in diabetes: 2010. Diabetes Care. 2010;33 Suppl 1:S11–61. - PMC - PubMed
    1. International Diabetes Federation Clinical Guidelines Task Force . Global guideline for type 2 diabetes. Brussels: International Diabetes Federation; 2005.
    1. World Health Organization Regional Office for the Western Pacific . Type 2 diabetes: practical targets and treatments. 4th ed. Melbourne: International Diabetes Institute; 2005.

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