Current status of managing diabetes mellitus in Korea
2
조회
0
다운로드
22
인용
0
참고문헌
키워드
초록
Diabetes mellitus is an increasing global health problem. Guidelines for diabetic care recommend management of lifestyle and risk factors (glucose, blood pressure, and cholesterol), as well as regular screening for complications associated with treatment of the conditions related to diabetes. The prevalence of diabetes increased from 8.6% to 11.0% from 2001 to 2013. According to the diabetes fact sheet 2015, the proportion of patients with diabetes treated with antihypertensive medications increased from 56.0% to 62.5% from 2006 to 2013, and 49.5% of those with diabetes were being treated with lipid-lowering medications in 2013, a 1.8-fold increase since 2006. According to the 2014 Korea National Health and Nutrition Examination Survey data, 45.6% of patients with diabetes achieved a hemoglobin A1c level of < 7.0%, 72.8% achieved a blood pressure of < 140/85 mmHg, and 58.0% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. Only 19.7% of patients with diabetes had good control of all three of these parameters. Despite improvements in health promotion efforts, the rates of adherence to medication and risk-factor control are low. Therefore, a systematic approach to managing diabetes, including self-management education, is needed to prevent or delay complications. The government needs to establish a long-term policy to address the growing burden of diabetes.
Abstract
Diabetes mellitus is an increasing global health problem. Guidelines for diabetic care recommend management of lifestyle and risk factors (glucose, blood pressure, and cholesterol), as well as regular screening for complications associated with treatment of the conditions related to diabetes. The prevalence of diabetes increased from 8.6% to 11.0% from 2001 to 2013. According to the diabetes fact sheet 2015, the proportion of patients with diabetes treated with antihypertensive medications increased from 56.0% to 62.5% from 2006 to 2013, and 49.5% of those with diabetes were being treated with lipid-lowering medications in 2013, a 1.8-fold increase since 2006. According to the 2014 Korea National Health and Nutrition Examination Survey data, 45.6% of patients with diabetes achieved a hemoglobin A1c level of < 7.0%, 72.8% achieved a blood pressure of < 140/85 mmHg, and 58.0% achieved a low density lipoprotein cholesterol level of < 100 mg/dL. Only 19.7% of patients with diabetes had good control of all three of these parameters. Despite improvements in health promotion efforts, the rates of adherence to medication and risk-factor control are low. Therefore, a systematic approach to managing diabetes, including self-management education, is needed to prevent or delay complications. The government needs to establish a long-term policy to address the growing burden of diabetes.
참고문헌 (45)
- Guariguata L, "Global estimates of diabetes prevalence for 2013 and projections for 2035", Diabetes Res Clin Pract, 103, pp.137~149 (2014)
- Lozano R, "Global and regional mortality from 235 causes of death for 20 age groups in 1990and 2010: a systematic analysis for the Global Burden of Disease Study 2010", Lancet, 380, pp.2095~2128 (2012)
- American Diabetes Association, "Economic costs of diabetes in the U.S. in 2012", Diabetes Care, 36, pp.1033~1046 (2013)
- Alva ML, "The impact of diabetes-related complications on healthcare costs: new results from the UKPDS (UKPDS 84)", Diabet Med, 32, pp.459~466 (2015)
- Inzucchi SE, "Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes", Diabetes Care, 38, pp.140~149 (2015)
- 하경화, "Trends in the Diabetes Epidemic in Korea", Endocrinology and Metabolism, 30(2), pp.142~146 (2015), 대한내분비학회
- 박이병, "Diabetes Epidemics in Korea: Reappraise Nationwide Survey of Diabetes “Diabetes in Korea 2007”", Diabetes and Metabolism Journal, 37(4), pp.233~239 (2013), 대한당뇨병학회[DOI]
- 송영득, "Trends in Diabetes Incidence in the Last Decade Based on Korean National Health Insurance Claims Data", Endocrinology and Metabolism, 31(2), pp.292~299 (2016), 대한내분비학회
- Al-Saeed AH, "An inverse relationship between age of type 2 diabetes onset and complication risk and mortality: the impact of youth-onset type 2 diabetes", Diabetes Care, 39, pp.823~829 (2016)
- Berkowitz SA, "Age at type 2 diabetes onset and glycaemic control: results from the National Health and Nutrition Examination Survey (NHANES)2005-2010", Diabetologia, 56, pp.2593~2600 (2013)
- Wong J, "Timing is everything: age of onset influences long-term retinopathy risk in type 2 diabetes, independent of traditional risk factors", Diabetes Care, 31, pp.1985~1990 (2008)
- "Korean diabetes fact sheet 2015" (2011)[URL]
- Tabak AG, "Prediabetes: a high-risk state for diabetes development", Lancet, 379, pp.2279~2290 (2012)
- Nathan DM, "Impaired fasting glucose and impaired glucose tolerance: implications for care", Diabetes Care, 30, pp.753~759 (2007)
- Ylitalo KR, "Peripheral vascular disease and peripheral neuropathy in individuals with cardiometabolic clustering and obesity: National Health and Nutrition Examination Survey 2001-2004", Diabetes Care, 34, pp.1642~1647 (2011)
- American Diabetes Association, "6. Obesity management for the treatment of type 2 diabetes", Diabetes Care, 39(Suppl 1), pp.S47~S51 (2016)
- American Diabetes Association, "8. Cardiovascular disease and risk management", Diabetes Care, 39(Suppl 1), pp.S60~S71 (2016)
- 손장원, "Changing Clinical Characteristics according to Insulin Resistance and Insulin Secretion in Newly Diagnosed Type 2 Diabetic Patients in Korea", Diabetes and Metabolism Journal, 39(5), pp.387~394 (2015), 대한당뇨병학회[DOI]
- 전자영, "Current Status of Glycemic Control of Patients with Diabetes in Korea: The Fifth Korea National Health and Nutrition Examination Survey", Diabetes and Metabolism Journal, 38(3), pp.197~203 (2014), 대한당뇨병학회[DOI]
- Ko KS, "A clinical study on the complications of non-insulin-dependent diabetes mellitus in Korea", J Korean Diabetes Assoc, 15, pp.257~262 (1991)
- 김대중, "The Epidemiology of Diabetes in Korea", Diabetes and Metabolism Journal, 35(4), pp.303~308 (2011), 대한당뇨병학회
- Diabetes Control and Complications Trial Research Group, "Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus:Diabetes Control and Complications Trial", J Pediatr, 125, pp.177~188 (1994)
- The Diabetes Control and Complications Trial (DCCT)Research Group, "Effect of intensive diabetes management on macrovascular events and risk factors in the Diabetes Control and Complications Trial", Am J Cardiol, 75, pp.894~903 (1995)
- UK Prospective Diabetes Study Group, "Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38", BMJ, 317, pp.703~713 (1998)
- UK Prospective Diabetes Study (UKPDS) Group, "Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)", Lancet, 352, pp.837~853 (1998)
- Gaede P, "Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes", N Engl J Med, 348, pp.383~393 (2003)
- Gregg EW, "Changes in diabetes-related complications in the United States, 1990-2010", N Engl J Med, 370, pp.1514~1523 (2014)
- "Treatment guideline for diabetes 2015" (2011)[URL]
- "Adherence to long-term therapies: evidence for action" (2016)[URL]
- Garcia-Perez LE, "Adherence to therapies in patients with type 2 diabetes", Diabetes Ther, 4, pp.175~194 (2013)
- Ko SH, "Trends of antidiabetic drug use in adult type 2 diabetes in Korea in 2002-2013:nationwide population-based cohort study", Medicine, 95, pp.e4018~ (2016)
- Hyoung Joo Kim, "Association between blood glucose level derived using the oral glucose tolerance test and glycated hemoglobin level", The Korean Journal of Internal Medicine, 31(3), pp.535~542 (2016), 대한내과학회
- Forbes JM, "Mechanisms of diabetic complications", Physiol Rev, 93, pp.137~188 (2013)
- Nathan DM, "The diabetes control and complications trial", epidemiology of diabetes interventions and complications study at 30 years: overview, 2014, pp.37, 9~16
- 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)
- Lee WJ, "The relationship between diabetic retinopathy and diabetic nephropathy in a population-based study in Korea (KNHANES V-2, 3)", Invest Ophthalmol Vis Sci, 55, pp.6547~6553 (2014)
- Won JC, "Prevalence and clinical characteristics of diabetic peripheral neuropathy in hospital patients with type 2 diabetes in Korea", Diabet Med, 29, pp.e290~e296 (2012)
- 진동찬, "Major changes and improvements of dialysis therapy in Korea: review of end-stage renal disease registry", The Korean Journal of Internal Medicine, 30(1), pp.17~22 (2015), 대한내과학회[DOI]
- 이상열, "Prevalence of Chronic Complications in Korean Patients with Type 2 Diabetes Mellitus Based on the Korean National Diabetes Program", Diabetes and Metabolism Journal, 35(5), pp.504~512 (2011), 대한당뇨병학회
- Koo BK, "The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study", PLoS One, 9, pp.e110650~ (2014)
- Byun SH, "Screening for diabetic retinopathy and nephropathy in patients with diabetes: a nationwide survey in Korea", PLoS One, 8, pp.e62991~ (2013)
- Shi Y, "The global implications of diabetes and cancer", Lancet, 383, pp.1947~1948 (2014)
- Chung JH, "Suicidal ideation and suicide attempts among diabetes mellitus: the Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007 to 2012", J Psychosom Res, 77, pp.457~461 (2014)
- Han SJ, "Increased risk of suicidal ideation in Korean adults with both diabetes and depression", Diabetes Res Clin Pract, 101, pp.e14~e17 (2013)
- 이윤정, "Factors Associated for Mild Cognitive Impairment in Older Korean Adults with Type 2 Diabetes Mellitus", Diabetes and Metabolism Journal, 38(2), pp.150~157 (2014), 대한당뇨병학회[DOI]