Journal List > J Korean Diabetes > v.12(4) > 1054791

Ko, Kim, Oh, Lee, Shim, Woo, Kim, Kim, Kim, Kim, Kim, Jeong, Hong, Cho, Mok, Yoon, Kim, and Committee of Clinical Practice Guidelines, Korean Diabetes Association: 2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea

Abstract

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association revised and updated the ‘3rd Clinical Practice Guidelines’ at the end of 2010. In these guidelines, the committee recommends active screening of high risk individuals for early detection and added HbA1c level as a diagnostic criterion of type 2 diabetes to produce a more practical approach based on clinical studies performed in Korea. Furthermore, committee members emphasize that integrated patient education for self-management is an essential part of patient care. The drug treatment algorithm was also updated based on the degree of hyperglycemia and patient characteristics.

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Fig. 1.
Algorithm for the medical management of type 2 diabetes. OHA, oral hypoglycemic agents; LFT, liver function test; GI, gastrointestinal; eGFR, estimated glomerular filtration rate; CHF, congestive heart failure; DPP, dipeptidyl peptidase; GLP, Glucagonlike peptide; GIP, glucose-dependent insulinotropic peptide.
jkd-12-183f1.tif
Table 1.
Screening of diabetes in Korea
1. FPG, 75 g oral GTT, or HbA1c can be used as screening tests
2. Annual screening should begin at 40 years of age or at 30 years in adults with risk factors
3. If FPG or HbA1c is as follows, additional testing should be considered
 Stage 1: If FPG 100~109 mg/dL or HbA1c 5.7~6.0%, annual FPG and HbA1c should be repeated
 Stage 2: If FPG 110~125 mg/dL or HbA1c 6.1~6.4%, oral GTT should be performed

FPG, fasting plasma glucose; GTT, glucose tolerance test.

Table 2.
Diagnostic criteria for diabetes in Korea
A diagnosis of diabetes can be made from any one of the following four criteria.
1. FPG ≥ 126 mg/dL
2. 2 hr plasma glucose ≥ 200 mg/dL during the oral glucose tolerance testa
3. Classic symptoms of hyperglycemia or hyperglycemic crisis + a randomb plasma glucose level ≥ 200 mg/dL
4. HbA1c ≥ 6.5%

Normal activity should be maintained for at least three days before sampling.

In the absence of unequivocal hyperglycemia, blood sampling should be repeated.

FPG, fastingc plasma glucose.

a Glucose load containing the equivalent of 75 g of anhydrous glucose dissolved in water.

b “Random” is defined without regard to the time since the last meal.

c “Fasting” means no caloric intake for at least 8 hr.

Table 3.
Recommendation of glycemic target in patients with type 2 diabetes
1. Fasting, postprandial glucose, and HbA1c can be used as markers of glycemic status
2. Achievement and maintenance of intensive glycemic control are needed to prevent diabetic microvascular and macrovascular complications
3. Glycemic target should be individualized according to the specific clinical situation
4. HbA1c goal can be targeted ≤ 6.5% if recently diagnosed or in young patients without severe complication or hypoglycemia
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