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

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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
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J Korean Diabetes 2011;12(4):183-189.

Published online: 22 January 2011

DOI: https://doi.org/10.4093/jkd.2011.12.4.183

2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea

Seung-Hyun Ko1, Dong-Joon Kim2, Seung-Joon Oh3, Hye-Jin Lee4, Kang-Hee Shim5, Mi-Hye Woo6, Jun-Young Kim7, Nan-Hee Kim8, Jae-Taik Kim9, Chong Hwa Kim10, Hye Jin Kim11, In-Kyung Jeong3, Eun-Gyoung Hong12, Jae-Hyoung Cho1, Ji-Oh Mok1, Kun-Ho Yoon1, Sung-Rea Kim1; Committee of Clinical Practice Guidelines, Korean Diabetes Association

1Division of Endocrinology & Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea

2Department of Internal Medicine, Inje University College of Medicine, Goyang, Korea

3Division of Endocrinology & Metabolism, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea

4Division of Endocrinology, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea

5Department of Diabetes Education, Samsung Medical Center, Seoul, Korea

6Department of Clinical Nutrition, Kyung Hee University Medical Center, Seoul, Korea

7Department of Socialwork, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea

8Department of Internal Medicine, Korea University College of Medicine, Ansan, Korea

9Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea

10Division of Endicrinology & Metabolism, Sejong General Hospital, Seoul, Korea

11Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea

12Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

13Division of Endocrinology & Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea

Copyright © 2011 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Practice guideline, Type 2 diabetes mellitus, Diagnosis, Drug therapy

REFERENCES

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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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