Comprehensive approaches to diabetes in the elderly: adapting to evolving trends

Lee, Jeongmin; Kim, Kwang Joon; Park, Yang Sun; Lee, Yong-ho; Park, Kyeong Hye; Jung, Hee-Won; Cha, Bong-Soo; Kim, Hun-Sung; Kim, Chang Oh

doi:2025.40.6.1017

Korean J Intern Med > Volume 40(6); 2025 > Article

ORIGINAL ARTICLE

Endocrinology-metabolism

Korean J Intern Med. 2025;40(6):1017-1028. doi: https://doi.org/10.3904/kjim.2024.390

Comprehensive approaches to diabetes in the elderly: adapting to evolving trends

Jeongmin Lee¹, Kwang Joon Kim², Yang Sun Park^2,3, Yong-ho Lee⁴, Kyeong Hye Park⁵, Hee-Won Jung⁶, Bong-Soo Cha⁴, Hun-Sung Kim^7,8

, and Chang Oh Kim²

¹Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
²Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
³Metabolism-Dementia Institute, Yonsei University College of Medicine, Seoul, Korea
⁴Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
⁵Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
⁶Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
⁷Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
⁸Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea

Corresponding Author: Hun-Sung Kim , Tel: +82-2-3147-8425, Fax: +82-0508-926-9080, Email: 01cadiz@hanmail.net
Chang Oh Kim , Tel: +82-2-2228-2264, Fax: +82-2-393-6884, Email: cokim@yuhs.ac

Received: November 18, 2024; Revised: March 4, 2025; Accepted: April 22, 2025.

Abstract

Background/Aims: The prevalence of diabetes mellitus (DM) is increasing worldwide owing to aging. This nationwide study aimed to investigate the prevalence of DM and its management status among elderly Koreans.
Methods: We analyzed data from the Korea National Health and Nutrition Examination Survey (2019–2021) to assess the prevalence of DM, awareness, treatment rates, and glycemic control status among elderly Koreans aged ≥ 65 years.
Results: The prevalence of DM increased significantly from 2019 to 2021, reaching 30.9% among elderly Koreans by 2021. Women were older than men (73.7 ± 5.0 vs. 72.7 ± 4.9 years, p < 0.001) and had higher BMI than men (24.5 ± 3.0 vs. 25.1 ± 3.6 kg/m², p < 0.001). The waist circumference was 91.5 ± 8.8 cm in men and 88.8 ± 9.2 cm in women (p < 0.005). The prevalence of obesity among patients with DM was 44.5%, significantly higher in women (47.4%) than men (41.2%; p = 0.003). Women also had higher rates of hypertension and hypercholesterolemia than men (hypertension: 74.0% vs. 66.5%, p < 0.005; hypercholesterolemia: 53.0% vs. 38.5%, p < 0.001). Women exhibited higher awareness rates of DM compared to men. Awareness and treatment rates were higher in older individuals compared to those aged 30–64 years. Regarding glycemic control, the target achievement rate was 61.0% for HbA1c < 7.0% in the total age group, with nearly 27.6% achieving strict control (HbA1c < 6.5%).
Conclusions: Our study underscores the rising DM prevalence among elderly Koreans and emphasizes the need for age-tailored management approaches to optimize care.

Keywords: Aged ; Chronic disease ; Diabetes mellitus ; Health surveys ; Prevalence