Diabetes is a chronic condition characterized by high blood sugar levels resulting from the body’s inability to produce or effectively use insulin. This metabolic disorder can lead to various health complications if not properly managed. Globally, diabetes represents a significant public health concern, impacting millions of individuals and placing a substantial burden on healthcare systems.
Diabetes Landscape in Korea
Diabetes prevalence in South Korea has shown a consistent upward trend. Among Korean adults aged 30 years or older, the prevalence of diabetes was 15.5% in 2021–2022, affecting 5.3 million individuals. Prevalence increases with age, reaching 29.3% in adults aged 65 or older. While age-standardized prevalence among individuals aged 19 and older remained stable between 2011 and 2022, the overall number of people with diabetes has grown.
Diabetes incidence has fluctuated, decreasing from 8.1 per 1,000 persons in 2006 to 6.3 in 2014, before rising again to 7.5 per 1,000 persons in 2019. An increase in diabetes among younger adults is evident. Incidence of diagnosed diabetes in the 20-29 age group increased from 0.5 to 0.7 per 1,000 individuals (2006-2015), and from 2.0 to 2.6 per 1,000 in the 30-39 age group during the same period. The number of Koreans aged 19-39 with Type 2 diabetes more than doubled from 2010 to 2020.
Type 1 diabetes incidence has increased, rising from 1.1 per 100,000 persons in 1995 to 4.8 per 100,000 persons in 2016. Prediabetes prevalence in South Korea is substantial, with 46.7% of adults categorized as pre-diabetic in 2021, a notable rise from 27.1% in 2015. Urban areas exhibit a higher prevalence of Type 2 diabetes compared to rural areas, with rates of 14.5% in urban versus 8.6% in rural regions in 2005.
Factors Shaping Diabetes in Korea
Diabetes characteristics in Korea are shaped by an interplay of dietary patterns, lifestyle shifts, and genetic predispositions. Traditional Korean diets, historically rich in fermented foods and vegetables, have undergone changes with increased Westernization. This shift includes higher consumption of processed foods, refined carbohydrates, and animal fats, contributing to increased caloric intake and a risk of obesity and related metabolic disorders.
Lifestyle changes, particularly increasing urbanization and sedentary behavior, play a role. South Korea has experienced rapid urbanization, leading to reduced physical activity and more desk-bound occupations. This decrease in daily energy expenditure, combined with dietary changes, creates an environment conducive to weight gain and insulin resistance. The proportion of obese young adults with diabetes has increased, from 51.4% in 2006 to 72.4% in 2015.
Genetic predispositions contribute to diabetes manifestation in the Korean population. Individuals of East Asian descent, including Koreans, develop Type 2 diabetes at a lower Body Mass Index (BMI) compared to Western populations. This suggests a higher susceptibility to insulin resistance and pancreatic beta-cell dysfunction even without severe obesity. The “thrifty gene” hypothesis, which posits that certain genes optimized for periods of famine might be disadvantageous in modern affluent societies, is considered in this context.
Societal Aspects of Diabetes Management
Societal and cultural factors influence how diabetes is managed in South Korea. Emphasis on collective well-being and family harmony often means health decisions are made with family input, which can be supportive and, at times, a source of pressure regarding dietary choices or treatment adherence. Family support can be a motivator for individuals to manage their condition.
Public health initiatives in Korea recognize the growing burden of diabetes, leading to efforts to improve awareness and early detection. The Korean Diabetes Association has lowered the recommended age for diabetes screening from 45 to 35 years, highlighting increasing prevalence among younger adults. Despite these efforts, awareness and treatment rates vary across age groups, with younger adults showing lower awareness and treatment compared to older adults.
Traditional health beliefs can impact diabetes management, with some individuals seeking complementary or alternative therapies alongside conventional medical treatments. While the healthcare system is robust, addressing diabetes requires navigating cultural nuances for effective long-term management. Over 70% of Korean adults with diabetes received antidiabetic treatment in 2021-2022, yet a smaller proportion achieved integrated management targets.