Diabetes in Korean Adults: Prevalence, Management, and Comorbidities

Abstract

[...]the ability of patients to meet integrated management goals—simultaneous control of glycemia, blood pressure, and lipids—remains suboptimal, with only 15.9% of patients successfully reaching these targets [1,4]. NOTES CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported. 1. Choi JH, Lee KA, Moon JH, Chon S, Kim DJ, Kim HJ, et al. 2023 Clinical practice guidelines for diabetes mellitus of the Korean Diabetes Association.

Diabetes mellitus is a critical public health issue in Korea, presenting a unique epidemiological and clinical profile influenced by cultural, genetic, and lifestyle factors. Recent findings from national surveys provide a comprehensive overview of the disease’s prevalence, management, and associated comorbidities among Korean adults, underscoring the urgent need for tailored healthcare interventions [1].

The prevalence of diabetes among Korean adults aged ≥30 years was 15.5% in 2021 to 2022, with a significant concentration in the elderly population (≥65 years), where nearly 30% were affected [1]. While there are indications of a plateau in overall diabetes rates, the situation among younger adults (19 to 39 years) is alarming. The prevalence of diabetes in this group has grown in tandem with obesity, with nearly 87% of young adults with diabetes now classified as obese. This serves as evidence suggesting that obesity is a major driver of diabetes in adolescents, and that the prevention and treatment of obesity could be crucial for preventing diabetes [1-3]. Korea has seen improvements in diabetes awareness and treatment rates, with 74.7% of diagnosed individuals being aware of their condition and 70.9% receiving treatment [1]. However, the ability of patients to meet integrated management goals—simultaneous control of glycemia, blood pressure, and lipids—remains suboptimal, with only 15.9% of patients successfully reaching these targets [1,4]. This disparity is particularly pronounced among younger adults, where awareness (43.3%) and treatment rates (34.6%) are notably lower, reflecting gaps in healthcare access and education for this demographic [1,5]. Conversely, older adults exhibit higher rates of awareness and treatment adherence, but struggle to achieve holistic control due to the complexities of managing multiple comorbid conditions. These findings highlight the importance of developing individualized management plans that consider both the clinical and social contexts of patients [6].

The coexistence of diabetes with other chronic conditions is a major challenge in Korea. Hypertension and hypercholesterolemia are the most common comorbidities, with their prevalence rising with age. Among older adults with diabetes, over 70% also suffer from hypertension, and more than half have hypercholesterolemia [1]. The synergistic impact of these conditions exacerbates the risk of cardiovascular complications, which remain a leading cause of mortality among diabetic patients [7]. For younger adults, the combination of diabetes and obesity creates a metabolic environment conducive to the early onset of complications, including non-alcoholic fatty liver disease and cardiovascular dysfunction [8]. This highlights the need for aggressive lifestyle interventions and early pharmacologic management to mitigate long-term risks [4].

The dual burden of increasing diabetes prevalence among young adults and persistent comorbidities among the elderly necessitates a multi-faceted approach. Public health initiatives should prioritize early screening and prevention by expanding targeted screening programs to identify at-risk populations, particularly in younger adults with obesity [2]. Patient-centered management should be emphasized by offering tailored care plans that address the unique challenges of managing diabetes in different age groups and with variable comorbidity profiles [9]. As diabetes continues to impose a major burden on Korean society, understanding its prevalence, management, and associated comorbidities is essential for developing effective strategies. By addressing the distinct needs of different patient groups, we can better mitigate the long-term societal and economic impacts of this chronic disease.

NOTES

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

References

1. Park SE, Ko SH, Kim JY, Kim K, Moon JH, Kim NH, et al. Diabetes fact sheets in Korea 2024. Diabetes Metab J 2025;49:24-33.

2. American Diabetes Association Professional Practice Committee. 3. Prevention or delay of diabetes and associated comorbidities: standards of care in diabetes-2025. Diabetes Care 2025;48(Supplement 1):S50-8.

3. American Diabetes Association Professional Practice Committee. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: standards of care in diabetes-2025. Diabetes Care 2025;48(Supplement 1):S167-80.

4. Choi JH, Lee KA, Moon JH, Chon S, Kim DJ, Kim HJ, et al. 2023 Clinical practice guidelines for diabetes mellitus of the Korean Diabetes Association. Diabetes Metab J 2023;47:575-94.

5. Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ, Bellary S. Type 2 diabetes in adolescents and young adults. Lancet Diabetes Endocrinol 2018;6:69-80.

6. Umegaki H. Management of older adults with diabetes mellitus: perspective from geriatric medicine. J Diabetes Investig 2024;15:1347-54.

7. Fang M, Wang D, Coresh J, Selvin E. Trends in diabetes treatment and control in U.S. adults, 1999-2018. N Engl J Med 2021;384:2219-28.

8. Gries JJ, Lazarus JV, Brennan PN, Siddiqui MS, Targher G, Lang CC, et al. Interdisciplinary perspectives on the co-management of metabolic dysfunction-associated steatotic liver disease and coronary artery disease. Lancet Gastroenterol Hepatol 2025;10:82-94.

9. American Diabetes Association Professional Practice Committee. 4. Comprehensive medical evaluation and assessment of comorbidities: standards of care in diabetes-2025. Diabetes Care 2025;48(Supplement 1):S59-85.