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

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.

Prevalence Estimation of Cataract based on a Screening Test

PURPOSE: To estimate the prevalence of cataracts based on screening test results and statistical estimation methods. METHODS: Between June 1994 and September 2005, 85,505 persons aged 20 years and older were screened at a health promotion center for a general health care screen. We assumed that all subjects had complete screening results; however some subjects had an unknown disease status. A 2x3 table form could be generated from this data set. To estimate cataract prevalence, we used a maximum likelihood estimation method to reconstruct a 2x2 table including probabilities for each cell. RESULTS: The overall estimated cataract prevalence was 13.98% (95% confidence intervals, 13.75% to 14.21%). We estimated the prevalence of cataracts to be 15.29% in men (95% confidence intervals, 14.95% to 15.63%) and 12.97% in women (95% confidence intervals, 12.65% to 13.29%). In addition, we found that the cataract prevalence distinctly increased in people aged 60 years or older. CONCLUSIONS: We found that these estimated cataract prevalences were not considerably different from study results obtained in other countries. Therefore, our method may be considered to be appropriate for estimating prevalence. Our results indicate that cataract prevalence in our study population increases with age and highlight the need for early detection and early interventions.