Diabetes screening in South Korea: a new estimate of the number needed to screen to detect diabetes
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Background/Aims: The Korean Diabetes Association (KDA) guidelines recommend adults aged ≥ 40 years and adults aged ≥ 30 years with diabetes risk factors for diabetes screening. This study aimed to determine the age threshold for diabetes screening in Korean adults. Methods: This study was based on the analyses of Korean adults aged ≥ 20 years using the Korea National Health and Nutrition Examination Survey (KNHANES) and the National Health Insurance Service-National Sample Cohort (NHIS-NSC). To evaluate screening effectiveness, we calculated the number needed to screen (NNS). Results: NNS to detect diabetes decreased from 63 to 34 in the KNHANES and from 71 to 42 in the NHIS-NSC between the ages of 30–34 and 35–39. When universal screening was applied to adults aged ≥ 35, the NNS was similar to that of adults aged ≥ 40. Compared to the KDA guidelines, the rate of missed screening positive in adults aged ≥ 20 decreased from 4.0% to 0.2% when the newly suggested screening criteria were applied. Conclusions: Universal screening for adults aged ≥ 35 and selective screening for adults aged 20 to 34, considering diabetes risk factors, may be appropriate for detecting prediabetes and diabetes in South Korea.
Abstract
Background/Aims: The Korean Diabetes Association (KDA) guidelines recommend adults aged ≥ 40 years and adults aged ≥ 30 years with diabetes risk factors for diabetes screening. This study aimed to determine the age threshold for diabetes screening in Korean adults. Methods: This study was based on the analyses of Korean adults aged ≥ 20 years using the Korea National Health and Nutrition Examination Survey (KNHANES) and the National Health Insurance Service-National Sample Cohort (NHIS-NSC). To evaluate screening effectiveness, we calculated the number needed to screen (NNS). Results: NNS to detect diabetes decreased from 63 to 34 in the KNHANES and from 71 to 42 in the NHIS-NSC between the ages of 30–34 and 35–39. When universal screening was applied to adults aged ≥ 35, the NNS was similar to that of adults aged ≥ 40. Compared to the KDA guidelines, the rate of missed screening positive in adults aged ≥ 20 decreased from 4.0% to 0.2% when the newly suggested screening criteria were applied. Conclusions: Universal screening for adults aged ≥ 35 and selective screening for adults aged 20 to 34, considering diabetes risk factors, may be appropriate for detecting prediabetes and diabetes in South Korea.
참고문헌 (35)
- Sun H, "IDF Diabetes Atlas : global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045", Diabetes Res Clin Pract, 183, pp.109119~ (2022)
- "Trend of diabetes prevalence" (2022)[URL]
- "National chronic disease statistics" (2022)[URL]
- 정찬희, "Diabetes Fact Sheets in Korea, 2020: An Appraisal of Current Status", Diabetes and Metabolism Journal, 45(1), pp.1~10 (2021), 대한당뇨병학회[DOI]
- Stitt AW, "Advanced glycation end products and diabetic complications", Expert Opin Investig Drugs, 11, pp.1205~1223 (2002)
- Wannamethee SG, "Impact of diabetes on cardiovascular disease risk and allcause mortality in older men : influence of age at onset, diabetes duration, and established and novel risk factors", Arch Intern Med, 171, pp.404~410 (2011)
- Zoungas S, "Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes", Diabetologia, 57, pp.2465~2474 (2014)
- Klein R, "Glycosylated hemoglobin predicts the incidence and progression of diabetic retinopathy", JAMA, 260, pp.2864~2871 (1988)
- Harris MI, "Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis", Diabetes Care, 15, pp.815~819 (1992)
- Hu FB, "Elevated risk of cardiovascular disease prior to clinical diagnosis of type 2 diabetes", Diabetes Care, 25, pp.1129~1134 (2002)
- 허규연, "2021 Clinical Practice Guidelines for Diabetes Mellitus of the Korean Diabetes Association", Diabetes and Metabolism Journal, 45(4), pp.461~481 (2021), 대한당뇨병학회[DOI]
- Korean Diabetes Association, "2007 Treatment Guideline for Diabetes", Korean Diabetes Association, ~ (2007)
- 최현호, "Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study", Diabetes and Metabolism Journal, 46(5), pp.803~807 (2022), 대한당뇨병학회[DOI]
- Kweon S, "Data resource profile : the Korea National Health and Nutrition Examination Survey(KNHANES)", Int J Epidemiol, 43, pp.69~77 (2014)
- Lee J, "Cohort profile : the National Health Insurance Service-National Sample Cohort(NHISNSC), South Korea", Int J Epidemiol, 46, pp.e15~ (2017)
- Korean Diabetes Association, "2021 Clinical Practice Guidelines for Diabetes", Korean Diabetes Association, ~ (2021)
- 김보연, "2020 Korean Society for the Study of Obesity Guidelines for the Management of Obesity in Korea", Journal of Obesity & Metabolic Syndrome, 30(2), pp.81~92 (2021), 대한비만학회[DOI]
- 조소미, "Dyslipidemia Fact Sheets in Korea 2020: an Analysis of Nationwide Population-based Data", 지질·동맥경화학회지, 10(2), pp.202~209 (2021), 한국지질동맥경화학회[DOI]
- Rembold CM, "Number needed to screen : development of a statistic for disease screening", BMJ, 317, pp.307~312 (1998)
- Chung S, "Reconsidering the age thresholds for type II diabetes screening in the U. S", Am J Prev Med, 47, pp.375~381 (2014)
- US Preventive Services Task Force, "Screening for prediabetes and type 2 diabetes : US Preventive Services Task Force recommendation statement", JAMA, 326, pp.736~743 (2021)
- American Diabetes Association Professional Practice Committee, "2. Classification and diagnosis of diabetes : standards of medical care in diabetes-2022", Diabetes Care, 45(Suppl 1), pp.S17~S38 (2022)
- Leiter LA, "Diabetes Screening in Canada(DIASCAN)Study : prevalence of undiagnosed diabetes and glucose intolerance in family physician offices", Diabetes Care, 24, pp.1038~1043 (2001)
- Diabetes Canada Clinical Practice Guidelines Expert Committee, "Screening for diabetes in adults", Can J Diabetes, 42(Suppl 1), pp.S16~S19 (2018)
- 하경화, "Clinical Characteristics of People with Newly Diagnosed Type 2 Diabetes between 2015 and 2016: Difference by Age and Body Mass Index", Diabetes and Metabolism Journal, 42(2), pp.137~146 (2018), 대한당뇨병학회[DOI]
- 배재현, "Diabetes Fact Sheet in Korea 2021", Diabetes and Metabolism Journal, 46(3), pp.417~426 (2022), 대한당뇨병학회[DOI]
- Lascar N, "Type 2 diabetes in adolescents and young adults", Lancet Diabetes Endocrinol, 6, pp.69~80 (2018)
- Jonas D, "Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: An Evidence Review for the U.S. Preventive Services Task Force. Evidence Synthesis No. 207", Agency for Healthcare Research and Quality, ~ (2021)
- Hamman RF, "Effect of weight loss with lifestyle intervention on risk of diabetes", Diabetes Care, 29, pp.2102~2107 (2006)
- Li G, "Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study : a 23-year follow-up study", Lancet Diabetes Endocrinol, 2, pp.474~480 (2014)
- Gong Q, "Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance : 30-year results of the Da Qing Diabetes Prevention Outcome Study", Lancet Diabetes Endocrinol, 7, pp.452~461 (2019)
- Rooney MR, "Risk of progression to diabetes among older adults with prediabetes", JAMA Intern Med, 181, pp.511~519 (2021)
- Choi G, "Association of prediabetes with death and diabetic complications in older adults : the pros and cons of active screening for prediabetes", Age Ageing, 51, pp.afac116~ (2022)
- Bonora E, "The pros and cons of diagnosing diabetes with A1C", Diabetes Care, 34(Suppl 2), pp.S184~S190 (2011)
- 전자영, "Prevalence of Diabetes and Prediabetes according to Fasting Plasma Glucose and HbA1c", Diabetes and Metabolism Journal, 37(5), pp.349~357 (2013), 대한당뇨병학회[DOI]