The prevalence of diabetic complications in Korea.

In order to elucidate the prevalence of individual complications and its relation to the age of patients and to the duration of diabetes in Korean diabetics, the authors observed 1442 diabetic patients (816 males and 626 females, with the age range 11 to 86) who were treated at the Chonnam University Hospital from 1982 to 1986. The results were as follows: 1) The overall prevalence of the diabetic complication was 38.6%, and prevalence of age group under 20 was 31%, and 30%, 24%, 31%, 45% and 49% for 3rd, 4th, 5th, 6th and over 6th decade, respectively. An increase in incidence after 40 years of age was noted. Among all complications, cardiovascular complication (25.7%) had the highest incidence while others were in the following order neuropathy (24.2%), retinopathy (24.0%), nephropathy (15.5%), infection (10.5%), and acute diabetic coma (2.1%). The prevalence of complication was not significantly different in sexes, however, increasing prevalence was noted after 40 years of age. 2) In neuropathy, peripheral type was the most common, and background retinopathy was frequently observed. Proliferative diabetic retinopathy was reported in 22 cases from the total of 26 cases of retinopathy in patients over 40 years of age. Seventy percent of patients with nephropathy had proteinuria with no significant in BUN and creatinine levels; and the dominant groups was males over 40 years of age. 3) Hypertension was the most common cardiovascular complication with no gender difference, while atherosclerosis and cerebral thrombosis were frequently observed in males over 40 years of age. Foot gangrene was seen in all age groups but it was especially prevalent in males in their sixties. 4) Among infectious complications, pulmonary tuberculosis had the highest frequency (21.6%), and skin infection (19.2%), and urinary tract infection (17.4%) were common complications; also emphysematous pyelonephritis was found in 2 cases. These results suggest that chronic diabetic complications relate to the duration of the disease and to the age of patients. The prevalence rate of diabetic complications should be evaluated considering factors such as racial and socioeconomic conditions, and possible risk factors for individual complications. With the clinical use of insulin and antibiotics, mortality from acute diabetic complications, such as coma or infections, showed significant decrease in contrast to the increasing prevalence of late complications which became the major causes of fatality in diabetics. Although these chronic complications were rising, determination of the exact prevalence in the population was difficult and varied in every report due to their occurrence in various combinations. This study was performed to elucidate (1) the prevalence of individual complication and (2) its relation to the age of patients and (3) its relation to the duration of diabetes in korean diabetics.