Trends in Cardiovascular Complications and Mortality among Patients with Diabetes in South Korea

Park, Jung Hwan; Ha, Kyoung Hwa; Kim, Bo Yeon; Lee, Jae Hyuk; Kim, Dae Jung

doi:10.4093/dmj.2020.0175

Cited by 48 publications

(37 citation statements)

References 19 publications

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“…The increasing prevalence of obesity has led to significant increases in the prevalence and incidence of T2DM [14]. However, among patients with diabetes, there has been a contrasting decrease in the incidence of CVD or CV death within the last two decades [6,[15][16][17][18][19][20][21]. Analysis of the Swedish nationwide registry data from 1998 to 2014 showed that there was a marked reduction of 20% in hospitalization for CVD and CV mortality among patients with T2DM [16].…”

Section: Epidemiology Of Cvdmentioning

confidence: 99%

“…These trends of CVD prevalence in diabetes are consistent with those reported by Asian studies. Analyses using data from the National Health Insurance Service database of Korea indicated that the incidence of CVD in T2DM has been decreasing annually [20,21]. Although the overall incidence rate of CVD shows decreasing trends, there has been some evidence of a paradoxical increase in heart failure (HF) in adults with diabetes [21,22].…”

Section: Epidemiology Of Cvdmentioning

confidence: 99%

“…Analyses using data from the National Health Insurance Service database of Korea indicated that the incidence of CVD in T2DM has been decreasing annually [20,21]. Although the overall incidence rate of CVD shows decreasing trends, there has been some evidence of a paradoxical increase in heart failure (HF) in adults with diabetes [21,22]. This finding may be due to ageing and advances in care and treatment that prolong survival after acute cardiac events, consequently increasing the number of patients with HF [22][23][24].…”

Section: Epidemiology Of Cvdmentioning

confidence: 99%

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Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes

Yun

2021

Metabolism

141

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With the advances in diabetes care, the trend of incident cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) has been decreasing over past decades. However, given that CVD is still a major cause of death in patients with diabetes and that the risk of CVD in patients with T2DM is more than twice that in those without DM, there are still considerable challenges to the prevention of CVD in diabetes. Accordingly, there have been several research efforts to decrease cardiovascular (CV) risk in T2DM. Large-scale genome-wide association studies (GWAS) and clinical cohort studies have investigated the effects of factors, such as genetic determinants, hypoglycaemia, and insulin resistance, on CVD and can account for the unexplained CV risk in T2DM. Lifestyle modification is a widely accepted cornerstone method to prevent CVD as the first-line strategy in T2DM. Recent reports from large CV outcome trials have proven the positive CV effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with high CVD risk. Overall, current practice guidelines for the management of CVD in T2DM are moving from a glucocentric strategy to a more individualised patient-centred approach. This review will discuss the current epidemiologic trends of CVD in T2DM and the risk factors linking T2DM to CVD, including genetic contribution, hypoglycaemia, and insulin resistance, and proper care strategies, including lifestyle and therapeutic approaches.

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Section: Epidemiology Of Cvdmentioning

confidence: 99%

Section: Epidemiology Of Cvdmentioning

confidence: 99%

Section: Epidemiology Of Cvdmentioning

confidence: 99%

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Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes

Yun

2021

Metabolism

141

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“…The increase of prevalence rate may be due to a decrease in mortality in the elderly. We have shown that mortality is decreasing in people with diabetes in the period 2007 to 2015 [15]. Another explanation is that national and individual activities including education and campaigns to prevent diabetes for people at high-risk of diabetes might have led to decrease of diabetes incidence [16,17].…”

Section: Discussionmentioning

confidence: 86%

Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study

Choi¹,

Choi²,

Yoon³

et al. 2022

Diabetes Metab J

Self Cite

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We investigated the incidence of diagnosed diabetes in South Korean adults (aged ≥20 years) by analyzing data for the National Health Insurance Service-National Sample Cohort. From 2006 to 2015, the overall incidence rate of diagnosed diabetes decreased by approximately 0.1% per year until 2015. Although, this trend was observed in individuals aged 40 years or over, the rate increased slightly in the 20-29 and 30-39 years age groups, from 0.5 to 0.7 and 2.0 to 2.6 per 1,000 individuals, respectively. The proportion of obese young adults with diabetes increased remarkably, from 51.4% in 2006 to 72.4% in 2015. Thus, young adults need early identification and weight-control strategies to prevent diabetes.

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“…The incidence of CV events and deaths has been decreasing over the past two decades [11][12][13]. However, the healthcare expenditure for CV disease is higher (12-16.5%) than that for other diseases (0.2-0.4%) [14].…”

Section: Discussionmentioning

confidence: 99%

Association Between the Diabetes Drug Cost and Cardiovascular Events for Type 2 Diabetes in Korea: A National Health Insurance Service Database Analysis

Chung

Lee²,

Han

et al. 2021

Preprint

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Background: We aimed to investigate the long-term effects of diabetes drug costs on cardiovascular (CV) events and death. Methods: This retrospective observational study used the 2009–2018 National Health Insurance data in Korea. Among patients with type 2 diabetes, those who were taking antidiabetic drugs and did not have CV events before 2009 were included. Data on the annual cost of each diabetes drug were collected. The 10-year incidence of CV events (cardiac death, non-fatal myocardial infarction, stroke, hospitalization for heart failure, and coronary revascularization) and CV death were analyzed according to the diabetes drug cost quartiles (Q1 [the lowest] – Q4 [the highest]).Results: A total of 441,914 participants were enrolled (median age, 60 years; male, 57%). CV events and death occurred in 28.1% and 8.36% of patients, respectively. The overall diabetes drug cost was USD 271/year per person (range: 1–18,921). The 10-year incidence of CV events and death was lowest in Q3 and high in Q4 and Q1. After adjusting for CV risk factors, the risk of CV events increased in the sequential order of cost quartiles (hazard ratio (HR)=1 [ref], 1.102 [95% confidence interval (CI): 1.084–1.120], 1.137 [95% CI: 1.118–1.156], and 1.323 [95% CI: 1.3011.346]). The risk of CV death showed U-shaped pattern which was lowest in the Q3 (HR=0.943, 95% CI 0.903-0.984) and highest in the Q4 (HR= 1.234, 95% CI 1.182-1.287).Conclusion: The expenditure for diabetes drug affects 10-year CV events and death. Affording an appropriate diabetes cost at a similar CV risk is an independent protective factor for CV death.Trial registration: retrospectively registered

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Trends in Cardiovascular Complications and Mortality among Patients with Diabetes in South Korea

Cited by 48 publications

References 19 publications

Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes

Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes

Rising Incidence of Diabetes in Young Adults in South Korea: A National Cohort Study

Association Between the Diabetes Drug Cost and Cardiovascular Events for Type 2 Diabetes in Korea: A National Health Insurance Service Database Analysis

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