DiabetesFact Sheetin Korea2016
* N Seoul Tower on Namsan Mountain Autumn View
Diabetes Fact Sheet in Korea 2016
Summary•About4.8millionKoreans(13.7%),aged30yearsorolder,haddiabetesin2014.Inaddition,nearlyaquarterofKoreanadultshadprediabetes(impairedfastingglucose).
•However,threeoutof10personswithdiabeteswerenotawareoftheircondition.Nearlyhalfpersonswithdiabeteswereobeseorhypertensive,andonethirdhadhypercholesterolemia.Nearlyone-thirdofpersonswithdiabeteshadalbuminuriaordecreasedrenalfunction.
•Althoughmostpersonswithdiabetes(89.1%)wereundermedicaltreatment-mostlybeingtreatedwithoralhypoglycemicagents(80.2%),but10.8%ofthosehadremaineduntreated.
•Withrespecttotheoverallglycemiccontrol,43.5%reachedthetargetofHbA1c<7.0%,whereas23.3%reachedthetargetwhenthestandardwassettoHbA1c<6.5%,accordingtotheKoreanDiabetesAssociation(KDA)guideline.
Data sourceTheestimatedpercentagesandthetotalnumberofpersonsovertheageof30withdiabetesandprediabetesweredeterminedfromdatafromthe2013-2014KoreaNationalHealthandNutritionalExaminationSurvey(KNHANES)conductedbytheKoreaCentersforDiseaseControlandPrevention(KCDC)andtheKoreanMinistryofHealthandWelfare,appliedtoNationalPopulationCensusin2014(34.1millionKoreanswereages30yearsorolder;16.7millionmenand17.4millionwomen).
Year 2012 2013 2015 2016
Data source KNHANES KNHANES NHIS KNHANES
2007-2010 2011 2002-2013 2013-2014
Year applied to Korean census 2010 2011 2006-2013* 2014
Co-working Institute CDC CDC NHIS CDC
Prevalence of diabetes (%, n)§ 10.1% (3.2 M) 12.4% (4.0 M) 8.0% (2.7 M) 13.7% (4.8 M)
Prevalence of IFG (%, n) 19.9% (6.2 M) 19.3% (6.1 M) 25% 24.8% (8.3 M)
Awareness of diabetes (%) 73.4% 72% • 70.7%
No treatment for diabetes (%) 14.1% 11% • 10.8%
Treatment with insulin (%) 7.4% 11% 16.4% 8.9%
Glycemic control (< 6.5%, %) 29.5% 27.9% • 23.3%
Hypertension (%)§§ • 54.6% 62.5% 54.7%
Hypertension control (%)§§ 37% 39.5% • 69.1%
Dyslipidemia (%)† • 79.6% 49.5% 31.6%
Dyslipidemia control (%)† • 17.4% • 49.8%
Albuminuria (%)‡ • 27.3% • 23.9%
Chronic kidney disease (%)‡ • 10.0% • 12.5%
Diabetes in ESRD (%)†† • • 38.8% •
Diabetic neuropathy (%)‡‡ • 33.5% • •
Diabetic retinopathy (%)∫ • 18.6% 15.9% •
Prevalence of obesity (%)∬ 74.7% 44.4% • 48.6%
SUMMARY of DIABETES FACT SHEET IN KOREA
Available at http://www.diabetes.or.kr/
NHIS,nationalhealthinsuranceservice;M,million;IFG,impairedfastingglucose;ESRD,end-stagerenaldisease.
*FromtheNationalHealthInformationDatabasefromJanuary2002throughtoDecember2013.§Diagnosticofdiabetes,basedonfastingplasmaglucose(≥126mg/dL),currenttakingofanti-diabeticmedication,orpreviousdiagnosisin2012,andadditionofHbA1c≥6.5%in2013and2016.In2015,basedonICD-10code(E11-E14)andprescriptionofantidiabeticmedications.§§Definitionandcontrolrateofhypertension(systolicanddiastolicbloodpressure,mmHg),≥140/90ortakinganti-hypertensivemedicationand<130/80in2012and2013,ICD-10codeandtakinganti-hypertensivemedicationin2015,≥140/90ortakinganti-hypertensivemedication(s)and<140/85in2016.†Definitionandcontrolrateofdyslipidemia,oneormorethanoffollowing;hypercholesterolemia(totalcholesterol≥240mg/dLormedication(s)),hypertriglyceridemia(TG)(≥150mg/dL),hyper-lowdensitylipoprotein(LDL)-cholesterolemia≥160mg/dL),hypo-highdensitylipoprotein(HDL)-cholesterolemia(<40mg/dLformen;<50mg/dLforwomen),ortakingmedication,andallofallfollowing;<100mg/dLforLDL-C,<150mg/dLforTG,and>40mg/dL(men)/50mg/dL(women)forHDL-Cin2015;hypercholesterolemia(totalcholesterol≥240mg/dL)and<100mg/dLforLDL-Cin2016.‡Thedefinitionofalbuminuriaorchronickidneydiseaseinpersonwithdiabetesareincreasedalbuminuriadeterminedbyalbumin-creatinineratio>30ug/mgofcreatinineorestimatedglomerularfiltrationrate(eGFR)<60mL/min/1.73m2.GFR(mL/min/1.73m2)=175×(SCr)
-1.154×(Age)-0.203×(0.742iffemale),respectively.††DefinitionofESRD,ICD-10codeofrenalfailure(N18,N19)ortreatedwithrenalreplacementtherapy.‡‡Diabeticneuropathy,Questionnaire(MichiganNeuropathyScreeningInstrument,score≥3)and10gmonofilamentexam.∫Diabeticretinopathy,presenceofatleastonedefiniteretinalblothemorrhageand/ormicroaneurysmwithorwithoutmoreseverelesions(hardexudates,softexudates,intraretinalmicrovascularabnormalities,venousbleeding,newretinalvessels,fibroproliferations)Basedonthediagnosisinthemoreseverelyaffectedeyein2013. ∬Bodymassindex,23.0~24.9kg/m2foroverweightand≥25.0kg/m2forobesity,overweightandobesein2012,andobesein2013and2016.
※Citation:KoSHetal,Medicine (Baltimore).2016;LeeYHetal,Diabetes Metab J.2016;JeonJYetal,Diabetes Metab J.2014;AhnJHetal,Diabetes Metab J.2014;KoSHetal,Diabetes Metab J.2014;KimCSetal,Diabetes Metab J.2014;RohEetal,Diabetes Metab J.2013;JeonJYetal,Diabetes Metab J.2013;WonJCetal,Diabet Med.2012.
Theprevalenceofdiabetesamongadults30yearsorolderis13.7%(4.8Million).
13.7%
15.7%
30.4%
11.9%
30-3
9 ye
ars
30-3
9 ye
ars
50-5
9 ye
ars
50-5
9 ye
ars
Persons (1,000)
40-4
9 ye
ars
40-4
9 ye
ars
60-6
9 ye
ars
60-6
9 ye
ars
≥ 70
yea
rs
≥ 70
yea
rs
Prevalence of Diabetes
"Nearly 1 of 7 Korean adults have diabetes"
“More than 30% of persons aged ≥ 65 years have diabetes”
"While the prevalence of diabetes get reach the highest at age of 60~69 in men, it is constantly increasing along the age in women"
"The prevalence of diabetes is 1.4 times more common in persons with the lowest quartile of family incomes compared with those with the highest quartile"
4,810,000/
2,580,000/
1,951,000/
2,230,000/
124/ 80
/
521/
239/
748/
442/
729/
574/
457/
895/33.8%
24.1%
11.1%
5.7%
3.1%
2.1%
33.1%
27.2%
18.8%
12.1%
Diabetesisdefinedbyfastingplasmaglucose≥126mg/dL,HbA1c≥6.5%,currentanti-diabetesmedication(s),orpreviousdiagnosis.
Men Women
Women
Family incomes (lowest - highest)
MenTotal
17 Diabetes
≥ 30 years ≥ 65 years Men
1 2 3 4 1 2 3 4 1 2 3 4
Women15.1%
17.7%
12.6%
12.8%
14.7%
10.6%
11.7%
13.3%
10.2%
11.2%
13.4%
9.2%
TheprevalenceofIFGamongadults30yearsorolderis24.8%(8.3Million).
Impairedfastingglucose(IFG)wasdefinedbyfastingplasmaglucosewith100~125mg/dLinpersonwithoutdiabetes.
Prevalence of IFG
“Nearly 1 of 4 Korean adults have IFG”
Threeoutof10personswithdiabetesarenotawareoftheircondition,andtwoof5personswithdiabetes(diagnosedandundiagnosed)arenottakinganytreatmentfortheircondition.Diabetesawarenessislowestatageof40~49inbothsexes.
Diabetes Awareness
30-3
9 ye
ars
30-3
9 ye
ars
Men
Tota
l
Men
Wom
en
Wom
en
50-5
9 ye
ars
50-5
9 ye
ars
≥ 65
yea
rs
50-5
9 ye
ars
50-5
9 ye
ars
40-4
9 ye
ars
40-4
9 ye
ars
≥ 30
yea
rs
40-4
9 ye
ars
40-4
9 ye
ars
60-6
9 ye
ars
60-6
9 ye
ars
60-6
9 ye
ars
60-6
9 ye
ars
≥ 70
yea
rs≥
70 y
ears
≥ 70
yea
rs≥
70 y
ears
4,786/
3,473/
796/
425/
8,259/
1,354/
708/
1,511/
1,042/
457/
642/
668/
657/
29.6%
20.0%
67.0%
70.7%
75.9%
20.1%
24.4%
26.9%
26.2%
16.9%
11.2%
24.8%
30.3%78.4%
81.5%
27.1%
82.0%
87.4%
37.9%65.5%
68.7%
31.4%46.0%
85.2%
56.9%
Persons (1,000)
“Diabetes awareness among adults 30 years or older is 70.7%”
Men
Men
Women
Women
14 IFG14 IFG
310 Unawareness
Theprevalenceofobesityandabdominalobesityinpersonswithdiabetesare48.6%and58.9%,respectively.
•BMI,bodymassindex•Obesity:BMI≥25.0kg/m2,morbidobesity:BMI≥30.0kg/m2
•Abdominalobesityisdefinedbyusingwaistcircumference≥90cmformenand≥85cmforwomen.
Obesity in Diabetes
Obesity Abdominal Obesity
Mor
bid
obes
ity
Women Women
“Nearly half of persons with diabetes are obese”
Theprevalenceandcontrolrateofhypertensioninpersonswithdiabetesare54.7%and69.1%,respectively.
Hypertensionisdefinedbysystolic/diastolicbloodpressure≥140/90mmHgand/orantihypertensivemedications,andcontrolrateisdefinedbybloodpressurelessthan140/85mmHgbasedontheKDAguideline.
Hypertension in Diabetes
“In men aged 40~49 years with diabetes, fewer than half do not reach the blood pressure goal of < 140/85 mmHg”
≥ 30 years ≥ 65 years Men Women
52.3%
63.9%
76.6%
71.7%
69.1%38.9%
9.748.6%
48.1%
49.4%
8.0
12.1
40.1%
37.3%
58.9%
61.2% 55.9%
54.7%
58.0%
76.4%
Total TotalMen Men
12
Uncontrolledhypertension
12 Obesity
Prevalence
Control rate
Mostpersonswithdiabetes(80.2%)aretreatedwithoralhypoglycemicagents,but10.8%ofthemhaveremaineduntreated.
*Inpersonswithdiagnoseddiabetes.OHA,oralhypoglycemicagent(s)
Treatment of Diabetes
OHAonly80.2%
Insulin±OHA8.9%
Notreatment10.8%
Non-pharmacologicaltherapy0.1%
Thecontrolrateofglycemiaamongthepersonswithdiagnoseddiabetesis23.3%fortargetgoalofHbA1c<6.5%or43.5%for<7.0%.However,14.6%ofpersonswithdiabeteshaveHbA1c≥9.0%.
Inpersonswithdiagnoseddiabetes
Control Rate of Diabetes
“Only one of 4 persons with diabetes gets the glycemic target”
“Only one out of 11 persons with diabetes is using insulin therapy for glycemic control”
HbA1
c <
6.5%
23.3%
HbA1
c <
7%
43.5%
HbA1
c =
7.0~
8.9%
41.9%
HbA1
c ≥
9.0%
14.6%
14 IFG
111 Insulinuser
14 HbA1c
< 6.5%
≥ 30 years ≥ 65 years Men Women
Theprevalenceandcontrolrateofhypercholesterolemiainpersonswithdiabetesare31.6%and49.8%,respectively.
Hypercholesterolemiaisdefinedbytotalcholesterol≥240mg/dLormedication(s)andcontrolrateisdefinedbylow-densitylipoproteincholesterol(LDL-C)<100mg/dLbasedonKDAguideline.
Hypercholesterolemia in Diabetes
“More than half of persons with diabetes do not reach the LDL-C goal of < 100 mg/dL”
Theprevalenceofdiabeticnephropathy(albuminuriaordecreasedeGFR)is30.3%.
Thedefinitionofnephropathyisincreasedalbuminuriadeterminedbyalbumin-creatinineratio>30ug/mgofcreatinineand/orestimatedglomerularfiltrationrate(estimatedGFR,eGFR)<60mL/min/1.73m2.GFR(mL/min/1.73m2)byMDRDequation=175×(SCr)
-1.154×(Age)-0.203×(0.742iffemale).
Nephropathy in Diabetes
“Three among 10 persons with diabetes have albuminuria or decreased renal function”
≥ 30 years
Prevalence
≥ 65 years
Control rate
Albuminuria Decreased eGFR Nephropathy
26.1%
39.0%
23.9%
30.3%
23.1%
12.5%
49.8%
31.7%
27.6%
51.0%
53.2%
37.0%
45.1%
31.6%
14 IFG12 Uncontrolled
hypercholesterolemia
310 Nephropathy
Thepercentageofcomprehensivemanagementinpersonswithdiabetesis9.4%.
Amongpersonswithdiabetes,27.4%aresmokersand21.9%arehigh-riskdrinkers.And,37.9%aretakinga30-minwalkingexerciseregularly.
Comprehensive Management of Diabetes
Health Behaviors in Diabetes
“Only one among 10 persons with diabetes gets a comprehensive management for diabetes and associated co-morbidities”
“In men aged 30 ~ 49 years with diabetes, more than half are current smoker and fewer than half are regular exercisers”
Currentsmoking(percentageofadultswhohadsmokedatleast5packsofcigarettes(100cigarettes)duringtheirlifetimeandwhoarecurrentlysmokers),high-riskdrinking(morethansevenglassesinmenorfiveglassesinwomenonthesameoccasiononeachof2ormoreaweek),regularwalkingexerciseactivity(5daysormoreperweekandfor30minutesormoreperactivity)
ThecomprehensivemanagementisdefinedbyHbA1c<6.5%or<7.0%,systolic/diastolicbloodpressure<140/85mmHg,andLDL-C<100mg/dLinpersonswithdiagnoseddiabetesbasedonKDAguidelines.
Men
Men Women≥ 30 years
Women
44.0%
23.0%
38.3%
37.3%
9.4%
16.8%
17.3%
16.2%
8.9%
9.7%
High-risk drinking
< 7.0% of HbA1c
Current smoking
< 6.5% of HbA1c
Regular walking exercise
14 IFG
110 Comprehensive
management
12 Smoking
5.2%
2.6%