Diabetes burden and prevention in Korea and the Western Pacific Region.

Diabetes burden in the Western Pacific Region (WPR) is more problematic than in any other part of the world. In 2013, the International Diabetes Federation reported >382 million people are living with diabetes around the world. About 36%, approximately 138 million people with diabetes, are living in the WPR. In addition, in the WPR, from 2012 to 2013, 6 million diabetes mellitus cases were newly diagnosed, accounting for 54.5% of all type 2 diabetes mellitus (T2DM) cases diagnosed in the world during the same period. South Korea is no exception, and the prevalence of diabetes is estimated to be as high as 5 million people. The prevalence of T2DM in Korea increased from <1% in 1960 to >10% by early 2000. According to the Ansung-Ansan Cohort study, from 2001 to 2011, T2DM increased 54% and 60% in the 50(th) and 60(th) age groups, respectively. The main reason for the rapid increase in the prevalence of diabetes in Korea was the sudden growth in the economy, resulting in rapid urbanization. Moreover, scientific evidence suggests the dramatic increase in T2DM incidence and prevalence in Korea is related to the influence of economic development, health policy, urbanization, westernized diet, decreased physical activity, as well as an individual's health behavior changes. However, diabetes management response rate was low in the newly onset groups with <20%, but gradually increased up to around 90%, then declined to <80% after 16-20 year of developing T2DM, showing an "M" management pattern. The study results revealed that despite the successful implementation of the universal health insurance system in Korea beginning in 1987, people diagnosed with T2DM were not properly managing T2DM. Most developing countries in the WPR are emulating the Korean experiences. There is clear evidence that utilization of BED (Behavioral change, Exercise, and proper Diet) could be the best vector to fight against the diabetes tsunami in the WPR. From the Korean experiences the WPR, at high risk for T2DM, could learn to prevent, intervene, and properly manage T2DM in order to reduce diabetes-related morbidity and mortality.