Increasing Diabetes Incidence and Prevalence Among Koreans Aged Under 30 Years: Socioeconomic Disparities

The global burden of diabetes is increasing, with significant implications for young populations. However, data on trends in young-onset diabetes trends in East Asia remain limited. Moreover, the impact of socioeconomic status (SES) on the incidence and prevalence of young-onset diabetes in this region has not been fully investigated. This study aimed to assess temporal trends in the incidence and prevalence of diabetes mellitus among Korean individuals aged < 30 years, with a focus on disparities by SES.

Data from the Korean National Health Insurance Service database (2008-2021) were analyzed. The annual incidence and prevalence of type 1 (T1DM) and type 2 diabetes mellitus (T2DM) were calculated, and trends were assessed using sex- and SES-adjusted rate ratios (aRRs).

The incidence of T1DM increased from 3.02 (95% confidence interval [CI], 2.78-3.27) per 100,000 population in 2008 to 3.75 (95% CI, 3.45-4.06) in 2021, based on 11,392 newly diagnosed cases during the study period (mean ± standard deviation [SD] age, 16.28 ± 7.18 years; 47.27% male). A higher aRR was observed in females (aRR, 1.176; 95% CI, 1.124-1.232) and in the 0-14 age group. Prevalence more than doubled over the study period, rising from 21.82 (95% CI, 21.16-22.48) to 46.41 (95% CI, 45.33-47.49), based on populations ranging from 19.3 million in 2008 to 15.3 million in 2021. For T2DM, based on 98,887 incident cases (mean ± SD age, 22.96 ± 5.38 years; 57.26% male), incidence increased from 27.61 (95% CI, 26.87-28.36) to 60.45 (95% CI, 59.22-61.69). A higher aRR was observed in males (aRR, 1.250; 95% CI, 1.232-1.267) and in the 0-14 age group. Prevalence nearly quadrupled, increasing from 73.29 (95% CI, 72.08-74.49) to 270.37 (95% CI, 267.77-272.97), using the same denominator population as for T1DM. Both T1DM and T2DM incidence and prevalence were significantly higher among individuals with low SES.

The rising burden of diabetes among young Koreans, particularly among socioeconomically disadvantaged groups, underscores the need for targeted public health interventions and early detection programs.