Type 2 diabetes patients in Korea feel difficult to manage 60% of glycated hemoglobin
Sep 29, 2024
According to an investigation, patients with type 2 diabetes in Korea lack management of glycated hemoglobin, one of the diagnostic indicators.
Diabetes and Health (CEO Yeom Dong-sik), a domestic diabetes patient association, announced that despite the high recognition rate of glycated hemoglobin in Korean type 2 diabetes patients, it has not been able to effectively manage it based on the results of a survey of domestic type 2 diabetes patients. Glycosylated hemoglobin is not a cross-sectional blood sugar level, but an average of blood sugar control for 8 to 10 weeks, and it is an indicator of how well blood sugar control has been performed every day.
Diabetes and Health conducted a survey on 500 adult type 2 diabetes patients over the age of 19 from June 24 to July 5 through Hankook Research, a polling agency. The survey subjects were patients who were diagnosed with type 2 diabetes and are currently taking or administering the treatment.
Type 2 diabetes is a chronic progressive disease that causes reduced quality of life and increased risk of death due to diabetes-related complications.
The Korean Diabetes Association (2023) and American Diabetes Association (2024) guidelines recommend maintaining stable blood sugar, preventing complications, and improving health status and quality of life by managing it with the goal of strict blood sugar control from the beginning of diabetes diagnosis. However, according to the Korean Diabetes Fact Sheet (2022), diabetes currently has the lowest control rate (less than 6.5% of glycated hemoglobin) among the three major chronic diseases (diabetes, hypertension, and dyslipidemia), and even at less than 7.0% of glycated hemoglobin, half of them are failing to achieve their treatment goals.
The age group of type 2 diabetic patients who participated in the survey was 5% in their 20s and 30s, 28% in their 40s, 33% in their 50s, and 34% in their 60s or older, and 27% in less than five years and 73% in more than five years of prevalence. 83% were accompanied by comorbidities, followed by dyslipidemia (51%), hypertension (50%), and obesity (23%).
First, the majority (91%) of type 2 diabetic patients knew glycated hemoglobin, but 75% answered that they knew that glycated hemoglobin was not only a diagnostic indicator but also an indicator that could predict cardiovascular disease occurrence, which was relatively unfortunate (75%). This shows that a significant number of patients may overlook the need for glycated hemoglobin control to prevent cardiovascular disease, a major diabetes-related complication.
Professor Cha Bong-soo (Sinchon Severance Hospital Endocrine Medicine), chairman of the Korean Diabetes Association, said "Unlike the general public, diabetics have heard about glycated hemoglobin, but they may not understand the exact meaning and figures."Studies have shown that for every 1% reduction in glycated hemoglobin, diabetes-related mortality and all-cause mortality decrease by 14%, disease-specific risk of microvascular complications by 37%, peripheral vascular disease by 43%, and myocardial infarction, stroke, and heart failure by 14%, 12%, and 16%, respectively. In other words, continuous monitoring and management based on the understanding of glycated hemoglobin is essential to lower the risk of diabetes-related cardiovascular complications.'
On the other hand, 6 out of 10 patients were found to have difficulty managing glycated hemoglobin, even though most patients were undergoing correct medication (85%), regular medical staff counseling (84%), and regular glycated hemoglobin testing (83%) (achievement target rate of glycated hemoglobin control: 40%). In particular, the longer the duration of diabetes prevalence, the greater the likelihood of treatment failure (ach prevalence: less than 1 year, 47% for more than 1 year, less than 5 years, 40% for more than 5 years, and 34% for more than 10 years).
Choi Sung-hee, professor of endocrine medicine at Seoul National University Bundang Hospital, said "If the prevalence period of type 2 diabetes is prolonged, the pancreatic insulin secretion function gradually decreases, and insulin resistance is high, so blood sugar can continue to rise even with similar lifestyle treatments."As a result, patients with type 2 diabetes with a long prevalence period need to make sure that glycated hemoglobin levels are well managed to meet their treatment goals at least once every two to three months, and if blood sugar control is not satisfactory, efforts to control blood sugar more actively, such as checking lifestyle habits and adding appropriate drugs or considering the use of other drugs are needed."
The survey also included the management status of body mass index, one of the major risk factors for type 2 diabetes.
Obese type 2 diabetes patients are recommended to lose and maintain weight by more than 5% with medical nutrition and exercise therapy. However, the proportion of patients with type 2 diabetes who participated in the survey with overweight or obesity was 71%, both at the time of diagnosis and now, showing no significant difference.1 This reflects that most patients still struggle with weight management after diagnosis of type 2 diabetes.
Most (93%) of the actual patients responded that 'steady weight management' was important in managing type 2 diabetes, but only 54% were consistently managing their weight. As a result, only 5% of patients succeeded in losing weight to normal levels. Even including patients who are currently overweight or obese but have lost weight compared to the time of diagnosis, the success rate was only 13%.
As a result of analyzing why it is difficult to control weight in type 2 diabetes patients who are currently overweight, patients with comorbidities had difficulty controlling appetite/food (74% vs 65%), regular exercise (62% vs 53%), and lifestyle management (53% vs 38%) than patients without comorbidities.
Professor Park Se-eun of the Korean Diabetes Association (Kangbuk Samsung Hospital Endocrinology Department) said, "Obesity is a major cause of increasing the risk of type 2 diabetes. If type 2 diabetes patients lose 5-10% of their weight, glycated hemoglobin levels decrease by up to 1%, and if they lose 10-15%, they can improve metabolic indicators such as cholesterol and triglycerides. If they lose 9-13kg, they can effectively prevent death."Nevertheless, the weight management of diabetics has not yet been done properly, and weight control is more difficult, especially with comorbidities, so these high-risk groups should strive to manage both glycated hemoglobin and weight indicators together."
CEO of Diabetes and Health Yeom Dong-sik "We are pleased to find out the factors that failed to manage the disease of patients with type 2 diabetes in Korea through this survey, identify the difficulties patients experience in their treatment journey, and find clues to solve them.""Despite the increased awareness of glycated hemoglobin itself, the overall management was still not up to expectations, so I felt sorry and responsible." Based on the unmet needs of type 2 diabetes patients in Korea identified through this survey, the patient association will continue to do its best to provide the necessary assistance to patients. Also, is this survey a glycated hemoglobin for patients?I hope it will be an opportunity to study the meaning of weight, etc., and to check one's condition and start behavioral changes," he added.
Meanwhile, the representative diabetic patient association in Korea, 'Diabetes and Health', is a non-profit private organization based on the online diabetic community 'Diabetes and Health' with about 280,000 members. It strives to improve the rights and interests of diabetic patients by revitalizing the diabetic and guardian community, mentoring education, and specialist lectures.
Diabetes and Health (CEO Yeom Dong-sik), a domestic diabetes patient association, announced that despite the high recognition rate of glycated hemoglobin in Korean type 2 diabetes patients, it has not been able to effectively manage it based on the results of a survey of domestic type 2 diabetes patients. Glycosylated hemoglobin is not a cross-sectional blood sugar level, but an average of blood sugar control for 8 to 10 weeks, and it is an indicator of how well blood sugar control has been performed every day.
Diabetes and Health conducted a survey on 500 adult type 2 diabetes patients over the age of 19 from June 24 to July 5 through Hankook Research, a polling agency. The survey subjects were patients who were diagnosed with type 2 diabetes and are currently taking or administering the treatment.
Type 2 diabetes is a chronic progressive disease that causes reduced quality of life and increased risk of death due to diabetes-related complications.
The Korean Diabetes Association (2023) and American Diabetes Association (2024) guidelines recommend maintaining stable blood sugar, preventing complications, and improving health status and quality of life by managing it with the goal of strict blood sugar control from the beginning of diabetes diagnosis. However, according to the Korean Diabetes Fact Sheet (2022), diabetes currently has the lowest control rate (less than 6.5% of glycated hemoglobin) among the three major chronic diseases (diabetes, hypertension, and dyslipidemia), and even at less than 7.0% of glycated hemoglobin, half of them are failing to achieve their treatment goals.
The age group of type 2 diabetic patients who participated in the survey was 5% in their 20s and 30s, 28% in their 40s, 33% in their 50s, and 34% in their 60s or older, and 27% in less than five years and 73% in more than five years of prevalence. 83% were accompanied by comorbidities, followed by dyslipidemia (51%), hypertension (50%), and obesity (23%).
First, the majority (91%) of type 2 diabetic patients knew glycated hemoglobin, but 75% answered that they knew that glycated hemoglobin was not only a diagnostic indicator but also an indicator that could predict cardiovascular disease occurrence, which was relatively unfortunate (75%). This shows that a significant number of patients may overlook the need for glycated hemoglobin control to prevent cardiovascular disease, a major diabetes-related complication.
Professor Cha Bong-soo (Sinchon Severance Hospital Endocrine Medicine), chairman of the Korean Diabetes Association, said "Unlike the general public, diabetics have heard about glycated hemoglobin, but they may not understand the exact meaning and figures."Studies have shown that for every 1% reduction in glycated hemoglobin, diabetes-related mortality and all-cause mortality decrease by 14%, disease-specific risk of microvascular complications by 37%, peripheral vascular disease by 43%, and myocardial infarction, stroke, and heart failure by 14%, 12%, and 16%, respectively. In other words, continuous monitoring and management based on the understanding of glycated hemoglobin is essential to lower the risk of diabetes-related cardiovascular complications.'
On the other hand, 6 out of 10 patients were found to have difficulty managing glycated hemoglobin, even though most patients were undergoing correct medication (85%), regular medical staff counseling (84%), and regular glycated hemoglobin testing (83%) (achievement target rate of glycated hemoglobin control: 40%). In particular, the longer the duration of diabetes prevalence, the greater the likelihood of treatment failure (ach prevalence: less than 1 year, 47% for more than 1 year, less than 5 years, 40% for more than 5 years, and 34% for more than 10 years).
Choi Sung-hee, professor of endocrine medicine at Seoul National University Bundang Hospital, said "If the prevalence period of type 2 diabetes is prolonged, the pancreatic insulin secretion function gradually decreases, and insulin resistance is high, so blood sugar can continue to rise even with similar lifestyle treatments."As a result, patients with type 2 diabetes with a long prevalence period need to make sure that glycated hemoglobin levels are well managed to meet their treatment goals at least once every two to three months, and if blood sugar control is not satisfactory, efforts to control blood sugar more actively, such as checking lifestyle habits and adding appropriate drugs or considering the use of other drugs are needed."
The survey also included the management status of body mass index, one of the major risk factors for type 2 diabetes.
Obese type 2 diabetes patients are recommended to lose and maintain weight by more than 5% with medical nutrition and exercise therapy. However, the proportion of patients with type 2 diabetes who participated in the survey with overweight or obesity was 71%, both at the time of diagnosis and now, showing no significant difference.1 This reflects that most patients still struggle with weight management after diagnosis of type 2 diabetes.
Most (93%) of the actual patients responded that 'steady weight management' was important in managing type 2 diabetes, but only 54% were consistently managing their weight. As a result, only 5% of patients succeeded in losing weight to normal levels. Even including patients who are currently overweight or obese but have lost weight compared to the time of diagnosis, the success rate was only 13%.
As a result of analyzing why it is difficult to control weight in type 2 diabetes patients who are currently overweight, patients with comorbidities had difficulty controlling appetite/food (74% vs 65%), regular exercise (62% vs 53%), and lifestyle management (53% vs 38%) than patients without comorbidities.
Professor Park Se-eun of the Korean Diabetes Association (Kangbuk Samsung Hospital Endocrinology Department) said, "Obesity is a major cause of increasing the risk of type 2 diabetes. If type 2 diabetes patients lose 5-10% of their weight, glycated hemoglobin levels decrease by up to 1%, and if they lose 10-15%, they can improve metabolic indicators such as cholesterol and triglycerides. If they lose 9-13kg, they can effectively prevent death."Nevertheless, the weight management of diabetics has not yet been done properly, and weight control is more difficult, especially with comorbidities, so these high-risk groups should strive to manage both glycated hemoglobin and weight indicators together."
CEO of Diabetes and Health Yeom Dong-sik "We are pleased to find out the factors that failed to manage the disease of patients with type 2 diabetes in Korea through this survey, identify the difficulties patients experience in their treatment journey, and find clues to solve them.""Despite the increased awareness of glycated hemoglobin itself, the overall management was still not up to expectations, so I felt sorry and responsible." Based on the unmet needs of type 2 diabetes patients in Korea identified through this survey, the patient association will continue to do its best to provide the necessary assistance to patients. Also, is this survey a glycated hemoglobin for patients?I hope it will be an opportunity to study the meaning of weight, etc., and to check one's condition and start behavioral changes," he added.
Meanwhile, the representative diabetic patient association in Korea, 'Diabetes and Health', is a non-profit private organization based on the online diabetic community 'Diabetes and Health' with about 280,000 members. It strives to improve the rights and interests of diabetic patients by revitalizing the diabetic and guardian community, mentoring education, and specialist lectures.
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