Current Management of Type 2 Diabetes Mellitus in Primary Care Clinics in Korea

Abstract

BackgroundThis study investigated the overall status of diabetes control and screening for diabetic microvascular complications in patients with type 2 diabetes mellitus attending primary care clinics in Korea.MethodsIn this cross-sectional observational study, 191 primary care clinics were randomly selected across Korea from 2015 to 2016. In total, 3,227 subjects were enrolled in the study.ResultsThe patients followed at the primary care clinics were relatively young, with a mean age of 61.4±11.7 years, and had a relatively short duration of diabetes (mean duration, 7.6±6.5 years). Approximately 14% of subjects had diabetic microvascular complications. However, the patients treated at the primary care clinics had suboptimal control of hemoglobin A1c levels, blood pressure, and serum lipid levels, along with a metabolic target achievement rate of 5.9% according to the Korean Diabetes Association guidelines. The screening rates for diabetic nephropathy, retinopathy, and neuropathy within the past 12 months were 28.4%, 23.3%, and 13.3%, respectively.ConclusionThe overall status of diabetes management, including the frequency of screening for microvascular complications, was suboptimal in the primary care clinics. More efforts should be made and more resources need to be allocated for primary care physicians to promote adequate healthcare delivery, which would result in stricter diabetes control and improved management of diabetic complications.

Comprehensive Efforts Are Needed to Improve the Quality of Primary Diabetes Care in Korea

“…They found that the patients treated at primary care clinics had lower rates of achieving all three metabolic targets, with a rate of 5.9% compared to 21.5% for those who received care at the three tertiary hospitals. The screening rates for nephropathy, retinopathy, and neuropathy within the past 12 months at primary care clinics were 28.4%, 23.3%, and 13.3%, respectively [14]. These findings are consistent with those of other studies.…”

“…However, few studies have investigated the comprehensive performance of HbA1c testing, lipid profiling, and screening for microvascular complications that include neuropathy in addition to nephropathy and retinopathy. In this issue, Seo et al [14] investigated the overall status of diabetes control and screening for diabetic microvascular complications in patients with T2DM attending 191 primary care clinics and three tertiary hospitals in 2015 and 2016 in Korea. They found that the patients treated at primary care clinics had lower rates of achieving all three metabolic targets, with a rate of 5.9% compared to 21.5% for those who received care at the three tertiary hospitals.…”

“…Another noteworthy aspect of the study conducted by Seo et al [14] was their finding that the rates of patients who had not undergone screening for retinopathy and neuropathy at a tertiary hospital within the past 24 months were 39% and 55%, respectively, although only 312 patients from three tertiary hospitals in Seoul were included in that analysis. Additionally, only 21.5% of patients achieved all three metabolic target.…”

Does Diabetes Increase the Risk of Contracting COVID-19? A Population-Based Study in Korea

“…However, in Korea, oral medications are preferred for diabetes treatment, and insulin prescription rate is lower than that in other countries. Insulin is often used as the last treatment option, although its use has greatly increased by 4% to 19% in recent years [ 21 , 22 ]. The patient group treated with insulin within 2 to 4 years of diabetes diagnosis may be deemed susceptible to infection.…”

Questionnaire-based Survey of Demographic and Clinical Characteristics, Health Behaviors, and Mental Health of Young Korean Adults with Early-Onset Diabetes

“…Recent study showed that the overall status of type 2 diabetes management, including HbA1c levels, blood pressure, and serum lipid levels, was suboptimal in primary care clinics in Korea. 8 According to this report, the screening rates for diabetic nephropathy and retinopathy within the past one year in 2,915 patients with type 2 diabetes were 28.4%, and 23.3%, respectively, at primary care clinics when compared with 87.8%, and 49.7%, respectively, at tertiary hospitals in Korea. 8 …”