title: Improved trends in cardiovascular complications among subjects with type 2 diabetes in Korea: a nationwide study (2006-2013).
abstract: Representative data on the secular trends in cardiovascular disease (CVD) are limited in Asian populations with diabetes. We aimed to estimate the temporal trends in cardiovascular complications using Korean nationwide whole population-based claims data in subjects with and without diabetes.
  
  
  
  Type 2 diabetes was defined as a current medication history of anti-diabetic drugs and the presence of International Classification of Diseases (ICD)-10 codes (E11-E14) as diagnosis. We compared the 8-year rates of six cardiovascular complications [i.e., ischemic heart disease, acute myocardial infarction (AMI), ischemic stroke, hemorrhagic stroke, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG)] in Korean adults aged 30 years and older using data from four consecutive nationwide databases (2006-2007, 2008-2009, 2010-2011, and 2012-2013) of Korean national health insurance service.
  
  
  
  A total of 1,645,348, 1,971,559, 2,291,247, and 2,562,612 subjects with type 2 diabetes were found in the year of 2006-2007, 2008-2009, 2010-2011, and 2012-2013, respectively. Age and gender standardized rates of the six predefined cardiovascular complications decreased in Korean adults with type 2 diabetes during the study period. The greatest relative reductions were observed for hospitalization due to AMI (-37.28%), followed by hospitalizations due to ischemic stroke (-36.98%). In the overall population without type 2 diabetes, the greatest relative reductions were observed for hospitalization for hemorrhagic stroke (-29.47%), followed by hospitalization due to ischemic stroke (-28.92%). Relative decreases in all six predefined cardiovascular complications were generally more profound in adults with diabetes than in those without diabetes, which led to significant decrease in the relative risks of all six cardiovascular complications in subjects with diabetes over the past 8 years. However, people with diabetes still had a two- to sixfold higher risk of hospitalization for major CVD events and interventions than people without diabetes.
  
  
  
  Our findings suggest a significant reduction in the rate of people affected by CVD within the diabetic population. However, as the number of people with diabetes rises, the absolute burden of CVD will still be high in Korea.
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Seoul, Songpa-gu, 05505, South Korea.
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Kwangju, South Korea.
authors.forename: Jin Ook
authors.initials: JO
authors.lastname: Chung
authors.affiliation: Department of Biostatics, The Catholic University of Korea, Seoul, South Korea.
authors.forename: Kyungdo
authors.initials: K
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea.
authors.forename: Seung-Hyun
authors.initials: SH
authors.lastname: Ko
authors.affiliation: Depatment of Internal Medicine, Cardiovascular and Metabolic Center, Inje University Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Seoul, Nowon-gu, 139-707, South Korea. kskomd@paik.ac.kr.
authors.forename: Kyung Soo
authors.initials: KS
authors.lastname: Ko
authors.affiliation: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Seoul, Songpa-gu, 05505, South Korea. jypark@amc.seoul.kr.
authors.forename: Joong-Yeol
authors.initials: JY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Cardiovascular disease; Complications; National; Trend; Type 2 diabetes