Endocrinology and Metabolism

Original Articles

Clinical Study
Current Management of Type 2 Diabetes Mellitus in Primary Care Clinics in Korea: Da Hea Seo, Shinae Kang, Yong-ho Lee, Jung Yoon Ha, Jong Suk Park, Byoung-Wan Lee, Eun Seok Kang, Chul Woo Ahn, Bong-Soo Cha; Endocrinol Metab. 2019;34(3):282-290. Published online September 26, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.3.282

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Background

This 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.

Methods

In 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.

Results

The 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.

Conclusion

The 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.

Citations

Citations to this article as recorded by

Evidence of Overlapping Roles Between Clinics and Hospitals in Primary Care
Boram Sim, Jihye Shin, Hyun Woo Kim, Jin Yong Lee, Min-Woo Jo
Journal of Korean Medical Science.2025;[Epub] CrossRef
Efficacy and safety in tirzepatide‐treated Korean adults with type 2 diabetes—A post hoc analysis of SURPASS‐AP‐combo and SURPASS‐3
Byung Wan Lee, Chang Beom Lee, Soo Lim, Sin Gon Kim, Nan Hee Kim, Jong Chul Won, Woo Je Lee, Min Ju Kang, Ju Young Yuh, Li Ying Du, Hyojin Lim, Kyu Jeung Ahn
Diabetes, Obesity and Metabolism.2025; 27(12): 7110. CrossRef
Digital Healthcare and Diabetic Retinopathy: Patient Experience Innovation and Support for Diabetes Care
Sang Jun Park
The Journal of Korean Diabetes.2025; 26(4): 208. CrossRef
Efficacy and Safety of Pioglitazone/Metformin Fixed-Dose Combination Versus Uptitrated Metformin in Patients with Type 2 Diabetes without Adequate Glycemic Control: A Randomized Clinical Trial
Li-xin Guo, Lian-wei Wang, De-zeng Tian, Feng-mei Xu, Wei Huang, Xiao-hong Wu, Wei Zhu, Jun-Qiu Chen, Xin Zheng, Hai-Yan Zhou, Hong-Mei Li, Zhong-Chen He, Wen-Bo Wang, Li-Zhen Ma, Jun-Ting Duan
Diabetes Therapy.2024; 15(11): 2351. CrossRef
Analytical techniques for determination of metformin-thiazolidinediones combination antidiabetic drug
Imad Osman Abu Reid, Sayda Mohamed Osman, Somia Mohammed Bakheet
Journal of Pharmacy and Allied Medicine.2024; 2(2): 82. CrossRef
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Comparison of on-Statin Lipid and Lipoprotein Levels for the Prediction of First Cardiovascular Event in Type 2 Diabetes Mellitus
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Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai Integration Model (SIM)
Chun Cai, Yuexing Liu, Yanyun Li, Yan Shi, Haidong Zou, Yuqian Bao, Yun Shen, Xin Cui, Chen Fu, Weiping Jia
Frontiers of Medicine.2022; 16(1): 126. CrossRef
Comparison of Health Outcomes by Care Provider Type for Newly Diagnosed Mild Type 2 Diabetes Patients in South Korea: A Retrospective Cohort Study
Hee-Chung Kang, Jae-Seok Hong
Healthcare.2022; 10(2): 334. CrossRef
Management Status of Patients with Type 2 Diabetes Mellitus at General Hospitals in Korea: A 5-Year Follow-Up Study
Jin Hee Jung, Jung Hwa Lee, Hyang Mi Jang, Young Na, Hee Sun Choi, Yeon Hee Lee, Yang Gyo Kang, Na Rae Kim, Jeong Rim Lee, Bok Rye Song, Kang Hee Sim
The Journal of Korean Diabetes.2022; 23(1): 64. CrossRef
Type 2 Diabetes Mellitus with Early Dry Skin Disorder: A Comparison Study Between Primary and Tertiary Care in Indonesia
Lili Legiawati, Kusmarinah Bramono, Wresti Indriatmi, Em Yunir, Aditya Indra Pratama
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Long-Term Changes in HbA1c According to Blood Glucose Control Status During the First 3 Months After Visiting a Tertiary University Hospital
Hyunah Kim, Da Young Jung, Seung-Hwan Lee, Jae-Hyoung Cho, Hyeon Woo Yim, Hun-Sung Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef
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Anshul Sharma, Chen Lulu, Kee-Ho Song, Hae-Jeung Lee
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Questionnaire-based Survey of Demographic and Clinical Characteristics, Health Behaviors, and Mental Health of Young Korean Adults with Early-Onset Diabetes
Ji In Park, Hyunjeong Baek, Sang-Wook Kim, Ji Yun Jeong, Kee-Ho Song, Ji Hee Yu, Il Sung Nam-Goong, Eun-Hee Cho
Journal of Korean Medical Science.2021;[Epub] CrossRef
Sodium–Glucose Cotransporter 2 Inhibitors and Risk of Retinal Vein Occlusion Among Patients With Type 2 Diabetes: A Propensity Score–Matched Cohort Study
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The Journal of Korean Diabetes.2020; 21(3): 161. CrossRef
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Sung-Youn Chun, Dong Wook Kim, Sang Ah Lee, Su Jung Lee, Jung Hyun Chang, Yoon Jung Choi, Seong Woo Kim, Sun Ok Song
Diabetes & Metabolism Journal.2020; 44(6): 897. CrossRef
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Diabetes
Retrospective Analysis of the Efficacy of Dapagliflozin in Patients with Type 2 Diabetes in a Primary Clinic in Korea: Sang Hyun Park, Young Ju Choi, Eun-Jung Rhee, Kab Bum Huh; Endocrinol Metab. 2019;34(1):70-79. Published online March 21, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.1.70

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Background

We aimed to retrospectively analyze the efficacy of 10 mg dapagliflozin (DAPA), which is a sodium-glucose cotransporter-2 inhibitor, in Korean patients with type 2 diabetes who visited a primary diabetes clinic.

Methods

In total, 83 patients with type 2 diabetes, who received treatment with DAPA for the first time in a primary diabetes clinic between January 2015 and October 2015, were included in the study. The effect of DAPA in lowering glycosylated hemoglobin (HbA1c) levels was evaluated via chart review at 6 months follow-up. The patients were categorized into five groups according to add-on to or switched from other glucose-lowering agents: add-on to metformin (MET, n=10), add-on to MET+dipeptidyl peptidase 4 inhibitor (DPP4i, n=12), switched from sulfonylurea (SU, n=13), switched from DPP4i (n=11), and switched from thiazolidinedione (TZD, n=37). All the participants had already used MET for their regimen.

Results

Treatment with DAPA reduced HbA1c level by 1.2%±0.8%. Moreover, a significant decrease was observed in all subgroups: add-on to MET, −1.2%±0.7%; add-on to MET+DPP4i, −1.4%±0.8%; switched from SU, −1.4%±0.7%; switched from DPP4i, −0.5%±0.7%; and switched from TZD, −1.2%±0.9% (P<0.01). A significant decrease in body weight (−3.1±2.6 kg, P<0.001) was observed after DAPA administration. Estimated glomerular filtration rate and urine microalbumin were significantly decreased after 6 months of treatment with DAPA (−4.0±13.5 mL/min/1.73 m², P=0.03; −23.6±45.9 mg/L, P<0.001).

Conclusion

Treatment with DAPA, whether added to or switched from other glucose-lowering agents, significantly decreased HbA1c levels in Korean patients with type 2 diabetes who visited a single primary diabetes clinic. DAPA can be considered as an optimal second-line treatment for patients with type 2 diabetes, as supported by real-world evidence studies.

Citations

Citations to this article as recorded by

The sodium glucose co-transporter 2 inhibitor dapagliflozin ameliorates the fluid-retaining effect of the endothelin A receptor antagonist zibotentan
Vandana Veenit, Hiddo J L Heerspink, Christine Ahlström, Peter J Greasley, Stanko Skritic, Natalie van Zuydam, Donald E Kohan, Pernille B L Hansen, Robert I Menzies
Nephrology Dialysis Transplantation.2023; 38(10): 2289. CrossRef

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