🩺 [2025 Korean Diabetes Guidelines] At a Glance: What’s New and What Matters Most

 

The Korean Diabetes Association (KDA) has released its updated 2025 Clinical Practice Guidelines for Diabetes Management in Korea.
This 9th edition reflects the latest scientific evidence and provides practical, patient-centered approaches tailored to Korean clinical settings.

📄 Download the full guideline (PDF):
https://www.diabetes.or.kr/bbs/?code=guide&mode=view&number=2078&page=1&code=guide

대한당뇨병학회

🌐 Official announcement:

https://www.diabetes.or.kr/pro/

대한당뇨병학회

 

 

 

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🔎 What’s New in the 2025 Guideline?

✅ 1. Patient-Centered Care Emphasis

• Individualized treatment goals based on patient preferences
• Tailored strategies for older adults, comorbidities, and vulnerable populations

✅ 2. Integrated Management of Comorbidities

• Coordinated care for CVD, CKD, obesity, and hypertension
• Strong recommendation for GLP-1 RAs and SGLT2 inhibitors where appropriate

✅ 3. Korean-Specific Standards

• Defines BMI ≥ 23 as overweight and BMI ≥ 25 as obese
• Refined glycemic targets and diagnostic criteria adapted to Korean populations

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📋 Diagnostic Criteria for Diabetes and Prediabetes

 

Category	Fasting Glucose (FPG)	2-hr Glucose (OGTT)	Notes
Normal	<100 mg/dL	<140 mg/dL	Normal glycemic control
IFG (Impaired Fasting Glucose)	100–125 mg/dL	<140 mg/dL	Fasting glucose elevated
IGT (Impaired Glucose Tolerance)	<126 mg/dL	140–199 mg/dL	Postprandial glucose elevated
IFG + IGT	100–125 mg/dL	140–199 mg/dL	Both fasting and post-load glucose abnormal
Diabetes	≥126 mg/dL	≥200 mg/dL	Diagnostic threshold

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🍽 Nutrition & Lifestyle Recommendations

🥗 Medical Nutrition Therapy (MNT)

• MNT should be delivered by Registered Dietitians (RDNs)
• Proven benefits: improved glycemic control, weight and blood pressure reduction, better diet quality

🏃 Lifestyle Intervention

• Diet + physical activity is the most effective approach to prevent type 2 diabetes
• Long-term studies show reductions in all-cause and cardiovascular mortality

⚖️ Weight Management

• Goal: ≥5% weight loss for overweight or obese adults with T2DM
• Even modest weight loss improves outcomes

🩸 Self-Monitoring of Blood Glucose (SMBG)

• Individualized timing and frequency based on patient profile
• Postprandial glucose strongly correlates with HbA1c
• Fasting glucose more influential in those with uncontrolled diabetes

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🥦 Evidence-Based Diet Patterns

• ✅ Mediterranean, Vegetarian, Low-fat, and DASH diets are all acceptable if sustainable and culturally appropriate
• ✅ Intermittent Fasting (IF): Not recommended for children <12, adults >70, underweight individuals, pregnant or breastfeeding women
• ✅ Carbohydrate control: Should be tailored based on treatment goals
• ✅ Dietary fiber: At least 25g/day recommended (≥400g of vegetables & fruits)
• ✅ Limit sugar-sweetened beverages (SSBs) due to links with obesity and CVD
• ✅ Fat quality matters: Replace saturated/trans fats with unsaturated fats from whole foods
• 🚫 Supplements of unsaturated fats have not shown consistent benefit
• ✅ Sodium: Keep <2,300mg/day
• ✅ Protein intake for diabetic kidney disease: Avoid both excessive and overly restrictive intake (not below 0.8 g/kg/day)

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🧾 Other Key Points

🍷 Alcohol

• Avoid if possible—may increase risk of hypoglycemia and glycemic variability

🥤 Hypoglycemia Management

• 15–20g of glucose (e.g., tablets or juice) typically raises glucose by 45–60 mg/dL
• Follow up with a snack or meal to prevent recurrence

🤰 Pregnancy-Specific Recommendations

• Avoid excessive carb restriction due to risk of increased fat intake and insulin resistance
• Glycemic targets should approach those of healthy pregnancies to reduce perinatal complications

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👵 Special Considerations for Older Adults

• Consider cognitive status, fall risk, and polypharmacy
• HbA1c target can be relaxed (up to 7.5–8.5%) depending on frailty and comorbidities
• Emphasis on adequate protein intake to prevent malnutrition and sarcopenia

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📊 Summary of Recommended Glycemic Targets

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Category	T1DM/T2DM	High Risk	Elderly Pregnant (T1DM)	GDM/T2DM (Pregnancy)
Hyperglycemia Stage 2(>250 mg/dL)	<5% of time	<10%	Avoid	Not specified
Hyperglycemia Stage 1(>180 mg/dL)	<25%	<50%	<25%	Avoid >140 mg/dL
Target Range (TIR)	>70% of time(70–180 mg/dL)	>50%	>70% (63–140 mg/dL)	63–140 mg/dL
Hypoglycemia Stage 1(<70 mg/dL)	<4%	<4%	<4%	<4%
Hypoglycemia Stage 2(<54 mg/dL)	<1%	<1%	<1%	<1%

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✅ Takeaway

The 2025 Korean Diabetes Guidelines emphasize individualized care, lifestyle intervention, and real-world applicability.
Whether you’re a healthcare provider or a person living with diabetes, understanding these updates can empower better, safer care.

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📚 Citation
Korean Diabetes Association (2025). 2025 Clinical Practice Guidelines for Diabetes Management in Korea.
https://www.diabetes.or.kr/bbs/?code=guide&mode=view&number=2078&page=1&code=guide