The Korean Diabetes Association (KDA) said Thursday that it would change treatment guidelines by lowering the screening ages for diabetes from 40 to 35 for all adults and from 30 to 19 for adults with risk factors.
KDA announced the guideline change at a New Year news conference but did not disclose the timing for unveiling details.
“Diabetes that occurs at a younger age has higher insulin resistance and worse beta cell function,” said Professor Moon Min-kyung of the Endocrinology Department at Seoul National University Boramae Hospital. “In addition, complications can occur more due to the prolonged disease period. So, there have been suggestions that early screening is necessary."
Moon, a KDA executive for treatment, explained that the change results from evaluating which age is the most efficient to select based on the data from the National Health and Nutrition Survey, the Korea Insurance Corporation, and the Health Insurance Review and Assessment Service.
“Many patients who have not been diagnosed will be screened simply by lowering the overall adult standard from 40 to 35,” she said.
Moon also forecasted that the new medical guidelines would include changes in the type 2 diabetes drug treatment.
"There are many new studies on SGLT-2 (sodium-glucose cotransporter 2) inhibitors," she said. “The EMPEROR-Preserved study, the DELIVER study, and the EMPA-KIDNEY study will be reflected (on new guidelines).”
These studies contain that SGLT-2 inhibitors prevent or delay disease exacerbation in patients with heart failure in all ranges of left ventricular ejection.
At the meeting, some voiced the need to designate type 1 diabetes as a severe incurable disease.
"Type 1 diabetes is by no means low in severity compared to other severe incurable diseases,” said Professor Jin Sang-man of the Endocrinology Department at Samsung Medical Center.
“Given that the stoppage of insulin administration for only half a day in type 1 diabetes patients leads to the risk of death from ketosis and that there are other complications that cause serious disabilities, it should be managed differently from other types of diabetes classified as mild,” Jin said.
Jin explained that the reason why type 1 diabetes is excluded from severe incurable diseases is that annual medical expenses, which include only insulin prices, are low.
“Expensive continuous blood glucose measurement and automatic insulin injection devices, which are essential for treatment, are classified as "care expenses" and are excluded from medical expenses. Therefore, people think of it as a disease with annual medical costs of less than 1 million won ($810),” he said.
“If it is not a severe incurable disease, treatment at a higher-level general hospital is restricted, so patients must go to a primary medical institution,” Professor Jin said. “In primary medical institutions, it is difficult to offer advanced education necessary for continuous blood glucose measurement and automatic insulin injection.”
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