2019 Clinical Practice Guidelines for Type 2 Diabetes Mellitus in Korea

Kim, Mee Kyoung; Ko, Seung‐Hyun; Kim, Bo-Yeon; Kang, Eun Seok; Noh, Junghyun; Kim, Soo‐Kyung; Park, Seok-O; Hur, Kyu Yeon; Chon, Suk; Moon, Min Kyong; Kim, Nan‐Hee; Kim, Sang Yong; Rhee, Sang Youl; Kang-Woo, Lee; Kim, Jae Hyun; Rhee, Eun-Jung; Chun, SungWan; Yu, Sung Hoon; Kim, Dae Jung; Kwon, Hyuk Sang; Park, Kyong Soo

doi:10.4093/dmj.2019.0137

Cited by 189 publications

(185 citation statements)

References 31 publications

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“…There was a de nite increase of continuity in age group 40-59, compared to other age groups. Continuity was distinctively lower in young age (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), which can partly be explained by mild severity, less complication, and more frequent residential migration of the group. However, current phenomenon can pose an impending threat to the working population since legacy effect of diabetes has been recently reported 16 .…”

Section: Discussionmentioning

confidence: 99%

“…This conveys the large disparity between supply and demand of medical resources in Korea. 2019 American Diabetes Association guideline recommends that diabetes patients should meet their primary care givers every 2 to 3 months 2,25 . Moreover, prevalence of diabetes is closely related to residential location 26 , which implies local physicians can manage their patients in a more customized, communicative manner.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Continuity of Care and Related Factors in Diabetes Patients in Korea

Shin

Kim

Cho

et al. 2020

Preprint

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Background: Diabetes is one of the fastest growing diseases with approximately 463 million patients worldwide. It is established that to manage diabetes, continuity of care in primary care setting is crucial. We aim to statistically define and analyze factors of continuity that are associated with patient, clinic and geographical relationship.Methods: We used 2014~2015 claim data from National Health Insurance Service (NHIS), with 39,096 eligible outpatient attendances across 29,912 office-based clinics. We applied multivariable logistic regression to analyze factors that may affect three kinds of continuity of care index for each patient: most frequent provider continuity index (MFPC), modified-modified continuity index (MMCI), and continuity of care index (COC). Results: Mean value of continuity of care indices were MFPC 0.90, MMCI 0.96, COC 0.85. Among patient factors, old age above 80 (MFPC 0.81 [0.74-0.89], MMCI 0.84 [0.76-0.92], COC 0.81 [0.74-0.89]) and disability were strongly associated with lower continuity of care. Another significant factor was residential area: further the patients lived from their primary care clinic, lower the continuity of diabetes care (MFPC 0.74 [0.70–0.78], MMCI 0.70 [0.66–0.73], COC 0.74 [0.70–0.78]). Patients who lived in metropolitan area had higher continuity of care compared to other areas (metropolitan area, MFPC 1.19 [1.17-1.27], MMCI 1.17 [1.10-1.25], COC 1.19 [1.12-1.27]). There was no statistical significance among clinic factors, such as number of hired physicians or nurses hired per clinic, between the lower and the higher continuity of care groups.Conclusion: Geographical proximity of patient’s residential area and clinic location showed highest correlation as factor of continuity. Political support is necessary to geographically align the imbalance of supply and demand of medical needs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of Continuity of Care and Related Factors in Diabetes Patients in Korea

Shin

Kim

Cho

et al. 2020

Preprint

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“…The Korean Ministry of Food and Drug Safety continues to contraindicate the use of metformin for patients with T2DM and CKD stage 3b (creatinine clearance < 45 mL/ min or an eGFR < 45 mL/min/1.73 m 2 ). However, in 2019, the KDA revised its recommendations as follows [22]: Metformin is contraindicated in patients with an eGFR < 30 mL/min/1.73 m 2 ; metformin can be used cautiously in patients with an eGFR between 30 and 45 mL/min/1.73 m 2 .…”

Section: Recent Recommendations On the Use Of Metformin In Chronic Kimentioning

confidence: 99%

“…In 2019, the KDA revised its recommendation that patients with an eGFR < 60 mL/min/1.73 m 2 should discontinue metformin on the day of the procedure for up to 48 hours, and reinstituted metformin therapy if renal function has not declined following the procedure [22].…”

Section: Recent Recommendations Regarding Metformin Discontinu-ation mentioning

confidence: 99%

Metformin treatment for patients with diabetes and chronic kidney disease: A Korean Diabetes Association and Korean Society of Nephrology consensus statement

Hur

Kim

et al. 2020

Kidney Res Clin Pract

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The safety of metformin use for patients with type 2 diabetes mellitus (T2DM) and advanced kidney disease is controversial, and more recent guidelines have suggested that metformin be used cautiously in this group until more definitive evidence concerning its safety is available. The Korean Diabetes Association and the Korean Society of Nephrology have agreed on consensus statements concerning metformin use for patients with T2DM and renal dysfunction, particularly when these patients undergo imaging studies using iodinated contrast media (ICM). Metformin can be used safely when the estimated glomerular filtration rate (eGFR) is ≥ 45 mL/min/1.73 m 2. If the eGFR is between 30 and 44 mL/min/1.73 m 2 , metformin treatment should not be started. If metformin is already in use, a daily dose of ≤ 1,000 mg is recommended. Metformin is contraindicated when the eGFR is < 30 mL/min/1.73 m 2. Renal function should be evaluated prior to any ICM-related procedures. During procedures involving intravenous administration of ICM, metformin should be discontinued starting the day of the procedures and up to 48 hours postprocedures if the eGFR is < 60 mL/min/1.73 m 2 .

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“…If the initial HbA1c level is greater than or equal to 7.5% or the HbA1c goal is not achieved after 3 months of initiating monotherapy, dual or triple combination therapy can be considered using DPP-4i, sodium-glucose cotransporter-2 inhibitors (SGLT2i), thiazolidinediones, glucagon-like peptide 1 receptor agonists (GLP-1 RAs), SUs, glinides, a-glucosidase inhibitors, and insulin, according to patient circumstances. 10 The general recommendations have not changed from those in the 2017 and 2015 KDA guidelines. Despite the availability of newer agents, such as SGLT2i and GLP-1 RAs, SUs are still widely utilized.…”

mentioning

confidence: 99%

Effects of Co‐administration of Sulfonylureas and Antimicrobial Drugs on Hypoglycemia in Patients with Type 2 Diabetes Using a Case‐Crossover Design

et al. 2020

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Objectives The purpose of this study was to investigate the effect of sulfonylureas (SUs) and antimicrobial co‐administration on hypoglycemia in patients with type 2 diabetes mellitus (T2DM). Methods We conducted a case‐crossover study using the Korean Health Insurance Review and Assessment Service‐National Inpatient Sample database, using data from 2014 to 2016. Hospitalized adult patients with T2DM who were diagnosed with hypoglycemia and prescribed SUs for at least 120 days were included. Different risk ratings of severity of drug–drug interactions were considered, including “level X, D, or C” in Lexi‐Interact online and “contraindicated, major, or moderate” in Micromedex. Exposure to antimicrobials in the 30‐day period before the first hypoglycemia diagnosis was assessed. Two control periods (61–90 and 91–120 days) were matched before the diagnosis date. Conditional logistic regression analysis was conducted to compare the odds of antimicrobial exposure. Results A total of 9339 patients were included. The mean age of the patients was 71.3 ± 10.6 years, and 4818 (51.6%) were women. An increased risk of hypoglycemia was associated with co‐administration of SUs and certain antimicrobials (adjusted odds ratio [aOR] 2.56, 95% confidence interval [CI] 2.34–2.80). The antimicrobial agents that were associated with an increased risk of hypoglycemia, when co‐administered with SUs, were sulfonamides (aOR 2.99, 95% CI 1.99–4.52), fluoroquinolones (aOR 2.62, 95% CI 2.38–2.89), macrolides (aOR 2.48, 95% CI 1.88–3.27), and tetracyclines (aOR 1.56, 95% CI 1.05–2.33). Conclusions Co‐administration with SUs and certain antimicrobials increased the risk of hypoglycemia. Thus, clinically relevant interactions in patients concurrently using SUs and antimicrobials should be monitored, especially within 30 days after co‐administration.

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2019 Clinical Practice Guidelines for Type 2 Diabetes Mellitus in Korea

Cited by 189 publications

References 31 publications

Analysis of Continuity of Care and Related Factors in Diabetes Patients in Korea

Analysis of Continuity of Care and Related Factors in Diabetes Patients in Korea

Metformin treatment for patients with diabetes and chronic kidney disease: A Korean Diabetes Association and Korean Society of Nephrology consensus statement

Effects of Co‐administration of Sulfonylureas and Antimicrobial Drugs on Hypoglycemia in Patients with Type 2 Diabetes Using a Case‐Crossover Design

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