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30.4 kg/m
2
in the youngest age group to 24.4 kg/m
2
in the
oldest age group.
Several studies suggested that lowering blood pressure and
cholesterol levels and avoiding tobacco diminish the incidence
of cardiovascular diseases. Therefore, guidelines for diabetes
care recommend risk-factor control and regular screening
for complications in order to treat conditions related to
diabetes in their early stages. In Korea, according to National
Health Insurance Service (NHIS), medication adherence rate,
which estimated using the medication possession ratio, was
increased from 12.8 to 44.9 from 2002
–
2013. And, the propor-
tion of people with diabetes who treated with antihyper-
tensive medications increased from 56.0% to 62.5% from
2006
–
2013. And, 49.5% of people with diabetes were being
treated with lipid-lowering medication in 2013, which is
1.8-fold higher than in 2006. According the Korea National
Health and Nutrition Examination Survey (KNHANES)
studies in 2014, 45.6% of people with diabetes achieved
hemoglobin A1c (HbA1c) <7.0%, 72.8% of them achieved
blood pressure (BP) <140/85 mmHg and 58.0% of themachieved
LDL cholesterol <100 mg/dL. Only 19.7% of people with
diabetes were revealed to be good control of all three targets
(unpublished data). Control rates in 2014 were slightly
improved compared with the reports in the 2005 health
insurance data, where 40.3% achieved HbA1c <7.0%, 58.6%
achieved blood pressure (BP) <140/90 mmHg, 38.3% achieved
LDL cholesterol <100 mg/dL.
Nevertheless, subjects with type 2 diabetes had microvascular
complications (end stage renal disease, 1.2%; diabetic retinop-
athy, 15.9%). And, the presence of macrovascular compli-
cations was higher in subjects with type 2 diabetes than those
without diabetes (295 ischemic stroke, 248 ischemic heart
disease, 41 cerebral hemorrhage per 10,000 persons in dia-
betic subjects; 62 ischemic stroke, 59 ischemic heart disease,
17 cerebral hemorrhage per 10,000 persons in non-diabetic
subjects). Current smoking in people with diabetes was still
higher in men (men, 43.2%; women, 6.4%).
Diabetes and cancer have been closely linked to each
other epidemiologically and biologically. Convincing evidence
indicates that diabetes is associated with increased risk for
several cancers. In Korea, the presence of cancer-related hos-
pitalization was higher in subjects with type 2 diabetes than
those without diabetes. Specifically, in subjects with type 2
diabetes, hospitalization events of stomach cancer, colorectal
cancer, liver cancer, pancreatic cancer, lung cancer were 37.9,
43, 48, 17.6, and 36 per 10,000 persons, respectively.
As the Korean population ages and diabetes prevalence
increases, it becomes increasingly crucial to find ways to over-
come problems to good diabetes management. Diabetes self-
management education is an important element of care for
all people with diabetes and those at risk for developing the
disease. However, only 39.4% received education for diabetes
management at least once in Korea. Therefore, systematic
approach to management diabetes including self-manage-
ment education is needed in order to prevent or delay the
complications of diabetes. And, the government need to estab-
lish a long-termpolicy to address the growing burden posed by
diabetes.
S05-1
Social-economic impact of diabetes in New Zealand
Steve CREW
1
.
1
Diabetes New Zealand, Wellington, New Zealand
As in many other developed countries, diabetes is one of
New Zealand
’
s fastest-growing long-term conditions. Rising
occurrence replicates a blend of influences, including rising
prevalence, better uncovering of cases through increased
screening, slower development from uncomplicated to late-
stage disease and demographic change.
An estimated 257,000 people in New Zealand have diabetes as
at December 2014 or 6% of the population.
The prevalence of diabetes has been rising at an average of 7%
per year for the last eight years.
The prevalence of diabetes is increasing across all ethnic
groups and age groups; the largest increases in diabetes are
among adults aged 25
–
44 years, and at least one in six adults
aged 65 years and over has diabetes.
The increase in diabetes is consistent with trends in obesity.
The increasing occurrence of diabetes in New Zealand is
having a foremost bearing on our health system.
Diabetes, because it is a long-termcondition with the potential
for severe complications, has high health costs. For example,
the total direct health care costs for a person with diabetes in
New Zealand are approximately three times those for people
without diabetes.
More generally, the long-term effects of diabetes will have an
inclusive bearing on society. This is because an increasing
number of people may not be able to continue working as they
did before the onset of their diabetes. The cost of this loss of
productivity has been estimated as being more than direct
health care costs.
S05-2
Socio-economic impact and initiatives of diabetes in Indonesia
Sidartawan SOEGONDO
1
.
1
Department of Medicine, Faculty of
Medicine, University of Indonesia, Jakarta, Indonesia
Indonesia is a growing diabetic epidemic country despite
strong economic fundamentals, and improving standard of
living. Existences of many barriers to appropriate diabetes care
prevent many people from living a healthy and productive life.
This abstract mainly focus on the burden of diabetes, barriers
for improved diabetic care and steps that help Indonesia to
overcome the barriers. It is reported that two-third of diabetes
population is found in low to middle income countries. With
the average of 6%, urban cities in Indonesia are populated
with people living with diabetes. There are 7.6 million people
living with diabetes and 12.6 million others have pre diabetes
(National Health Survey in 2007). Fewer than half of those with
diabetes are aware of their condition. Less than one percent of
those who are aware and received diabetes treatment achieve
their goal of treatment. As results from the under diagnosed
and under treated, disability, loss of life and productivity due
to diabetes complications burden may negatively affect the
Indonesian economic progress. Today, with its low population
growth rate (1% annual growth rate since 2006), coupled with
solid productivity gains (5.6% of annual GDP rate) together
with stable inflation rate Indonesia has strong, long term
economic growth potential. The improving standard of living
in Indonesia is bringing with its lifestyle changes that increase
diabetes risk and prevalence, thereby hampering sustainable
economic growth. Demand for healthcare, however, may
outstrip the country
’
s ability to provide it. Four key barriers
of diabetes care in Indonesia include lack of awareness about
diabetes in the general public and among some healthcare
professionals and policy makers, inequity of healthcare sup-
ply and demand resulting from an expanding patient popula-
tion and too few diabetes specialists, lack of resources in the
public healthcare system and among Indonesian population,
and that too few people receiving appropriate treatment.
Analytical study was done to estimate long-term clinical and
economic impact of a 1% HbA1c reduction in patients with
type 2 diabetes in Indonesia. The analysis was performed
using the published and validated CORE Diabetes Model over a
time horizon of 35 years, with future costs and clinical benefits
discounted at a rate of 3% per annum. The analysis compared
patients outcomes in two groups. In the poorly controlled
patient arm, HbA1c remained at 9.8%, in comparison with
reducing mean HbA1c to 8.8% in the active arm. Mean HbA1c
was assumed to remain unchanged throughout the analysis.
All other physiological characteristics were equal in the two
treatment arms. Results of the study showed that 1% reduction
Speech Abstracts / Diabetes Research and Clinical Practice 120S1 (2016) S1
–
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