Background: Korea recently established 70 emergency medical service areas. However, there are many concerns that medical resources for stroke could not be evenly distributed through the country. We aimed to compare the treatment quality and outcomes of acute stroke among the emergency medical service areas. Methods: This study analyzed the data of 28,800 patients admitted in 248 hospitals which participated in the 8th acute stroke quality assessment by Health Insurance Review and Assessment Service. Individual hospitals were regrouped into emergency service areas according to the address of the location. Assessment indicators and fatality were compared by the service areas. We defined the appropriate hospital by the performance of intravenous thrombolysis. Results: In seven service areas, there were no hospitals which received more than 10 stroke patients for 6 months. In nine service areas, there were no patients who underwent intravenous thrombolysis (IVT). Among 167 designated emergency medical centers, 50 hospitals (29.9%) responded that IVT was impossible 24 hours a day. There are 97 (39.1%) hospitals that meet the definitions of appropriate hospital. In 23 service areas (32.9%) had no appropriate or feasible hospitals. The fatality of service areas with stroke centers were 6.9% within 30 days and 15.6% within 1 year from stroke onset than those without stroke centers (7.7%, 16.9%, respectively). Conclusions There was a wide regional gap in the medical resource and the quality of treatments for acute stroke among emergency medical service areas in Korea. The poststroke fatality rate of the service areas which have stroke centers or appropriate hospitals were significantly low.

Diabetes mellitus is rapidly increasing worldwide, especially in Africa and Asia. According to the Diabetes Fact Sheet in Korea 2018, the prevalence of diabetes in adults 30 years and older is 14.4% (5.01 million), indicating that nearly 1 in 7 Korean adults have diabetes. Another approximately 25% of adults 30 years and older (8.71 million people) have impaired fasting glucose, so-called “prediabetes.” Thus, 1 in 3 adults are diabetic or at risk for diabetes. The diabetic population is expected to reach approximately 6 million in 2050, representing two-fold growth over the next 40 years. Although the etiology of diabetes mellitus is multifactorial, obesity is suspected to be a main factor for the increasing prevalence in Korea. The average body mass index of diabetics is around 25 kg/m². Prevention is the best way to decrease the global burden of diabetes. Many trials on the prevention of type 2 diabetes mellitus (T2DM) have been performed. Lifestyle modification is one of the most powerful strategies for the prevention of T2DM, but medications are believed to be effective in certain populations. These preventive effects can vary according to ethnicity, sex, and genetic background. Although there is little evidence of potential pharmacotherapy for diabetes prevention in Korea, this lecture will review available medications in the context of T2DM prevention.
Adult ; Africa ; Asia ; Body Mass Index ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Drug Therapy ; Fasting ; Genetic Background ; Glucose ; Humans ; Korea ; Life Style ; Obesity ; Prevalence