Objective: This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic. Methods: Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously. Results: The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods. Conclusion The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.

Objective: This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic. Methods: Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously. Results: The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods. Conclusion The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.

Background: Given the association between nonalcoholic fatty liver disease and metabolic risks, a new term, metabolic dysfunction- associated steatotic liver disease (MASLD) has been proposed. We aimed to explore the association between MASLD and all-cause, cause-specific mortalities. Methods: We included individuals with steatotic liver disease (SLD) from the Korean National Health Insurance Service. Moreover, SLD was defined as a fatty liver index ≥30. Furthermore, MASLD, metabolic alcohol-associated liver disease (MetALD), and alcoholic liver disease (ALD) with metabolic dysfunction (MD) were categorized based on alcohol consumption and MD. We also analyzed all-cause, liver-, cancer-, hepatocellular carcinoma (HCC)- and cardiovascular (CV)-related mortalities. Results: This retrospective nationwide cohort study included 1,298,993 individuals aged 40 to 79 years for a mean follow-up duration of 9.04 years. The prevalence of MASLD, MetALD, and ALD with MD was 33.11%, 3.93%, and 1.00%, respectively. Relative to the “no SLD” group, multivariable analysis identified that MASLD (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.26 to 1.31), MetALD (aHR, 1.38; 95% CI, 1.32 to 1.44), and ALD with MD group (aHR, 1.80; 95% CI, 1.68 to 1.93) have a significantly higher risk of all-cause mortality. Furthermore, MASLD, MetALD, ALD with MD groups showed higher liver-, cancer- and HCC-related mortality than “no SLD” group. While all-cause specific mortalities increase from MASLD to MetALD to ALD with MD, the MetALD group shows a lower risk of CV-related mortality compared to MASLD. However, ALD with MD group still have a higher risk of CV-related mortality compared to MASLD. Conclusion SLD is associated with an increased risk of all-cause, liver-, cancer-, HCC-, and CV-related mortalities.

Background: This study compares the association between real-time continuous glucose monitoring (rtCGM) and intermittently- scanned CGM (isCGM) and glycemic control in individuals with type 1 diabetes mellitus (T1DM) in a real-world setting. Methods: Using data from the Korean National Health Insurance Service Cohort, individuals with T1DM managed by intensive insulin therapy were followed at 3-month intervals for 2 years after the initiation of CGM. The glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CVs) of rtCGM and isCGM users were compared using independent two-sample t-test and a linear mixed model. Results: The analyses considered 7,786 individuals (5,875 adults aged ≥19 years and 1,911 children and adolescents aged <19 years). Overall, a significant reduction in HbA1c level was observed after 3 months of CGM, and the effect was sustained for 2 years. The mean HbA1c level at baseline was higher in rtCGM users than in isCGM users (8.9%±2.7% vs. 8.6%±2.2%, P<0.001). However, from 3 to 24 months, rtCGM users had lower HbA1c levels than isCGM users at every time point (7.1%±1.2% vs. 7.5%±1.3% at 24 months, P<0.001 for all time points). In both adults and children, the greater reduction in HbA1c with rtCGM remained significant after adjusting for the baseline characteristics of the users. The CV also showed greater decrease with rtCGM than with isCGM. Conclusion In this large nationwide cohort study, the use of rtCGM was associated with a greater improvement in glycemic control, including HbA1c reduction, than the use of isCGM in both adults and children with T1DM.

Background: Given the association between nonalcoholic fatty liver disease and metabolic risks, a new term, metabolic dysfunction- associated steatotic liver disease (MASLD) has been proposed. We aimed to explore the association between MASLD and all-cause, cause-specific mortalities. Methods: We included individuals with steatotic liver disease (SLD) from the Korean National Health Insurance Service. Moreover, SLD was defined as a fatty liver index ≥30. Furthermore, MASLD, metabolic alcohol-associated liver disease (MetALD), and alcoholic liver disease (ALD) with metabolic dysfunction (MD) were categorized based on alcohol consumption and MD. We also analyzed all-cause, liver-, cancer-, hepatocellular carcinoma (HCC)- and cardiovascular (CV)-related mortalities. Results: This retrospective nationwide cohort study included 1,298,993 individuals aged 40 to 79 years for a mean follow-up duration of 9.04 years. The prevalence of MASLD, MetALD, and ALD with MD was 33.11%, 3.93%, and 1.00%, respectively. Relative to the “no SLD” group, multivariable analysis identified that MASLD (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.26 to 1.31), MetALD (aHR, 1.38; 95% CI, 1.32 to 1.44), and ALD with MD group (aHR, 1.80; 95% CI, 1.68 to 1.93) have a significantly higher risk of all-cause mortality. Furthermore, MASLD, MetALD, ALD with MD groups showed higher liver-, cancer- and HCC-related mortality than “no SLD” group. While all-cause specific mortalities increase from MASLD to MetALD to ALD with MD, the MetALD group shows a lower risk of CV-related mortality compared to MASLD. However, ALD with MD group still have a higher risk of CV-related mortality compared to MASLD. Conclusion SLD is associated with an increased risk of all-cause, liver-, cancer-, HCC-, and CV-related mortalities.

Background: This study compares the association between real-time continuous glucose monitoring (rtCGM) and intermittently- scanned CGM (isCGM) and glycemic control in individuals with type 1 diabetes mellitus (T1DM) in a real-world setting. Methods: Using data from the Korean National Health Insurance Service Cohort, individuals with T1DM managed by intensive insulin therapy were followed at 3-month intervals for 2 years after the initiation of CGM. The glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CVs) of rtCGM and isCGM users were compared using independent two-sample t-test and a linear mixed model. Results: The analyses considered 7,786 individuals (5,875 adults aged ≥19 years and 1,911 children and adolescents aged <19 years). Overall, a significant reduction in HbA1c level was observed after 3 months of CGM, and the effect was sustained for 2 years. The mean HbA1c level at baseline was higher in rtCGM users than in isCGM users (8.9%±2.7% vs. 8.6%±2.2%, P<0.001). However, from 3 to 24 months, rtCGM users had lower HbA1c levels than isCGM users at every time point (7.1%±1.2% vs. 7.5%±1.3% at 24 months, P<0.001 for all time points). In both adults and children, the greater reduction in HbA1c with rtCGM remained significant after adjusting for the baseline characteristics of the users. The CV also showed greater decrease with rtCGM than with isCGM. Conclusion In this large nationwide cohort study, the use of rtCGM was associated with a greater improvement in glycemic control, including HbA1c reduction, than the use of isCGM in both adults and children with T1DM.

Objective: This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic. Methods: Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously. Results: The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods. Conclusion The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.

Background: Given the association between nonalcoholic fatty liver disease and metabolic risks, a new term, metabolic dysfunction- associated steatotic liver disease (MASLD) has been proposed. We aimed to explore the association between MASLD and all-cause, cause-specific mortalities. Methods: We included individuals with steatotic liver disease (SLD) from the Korean National Health Insurance Service. Moreover, SLD was defined as a fatty liver index ≥30. Furthermore, MASLD, metabolic alcohol-associated liver disease (MetALD), and alcoholic liver disease (ALD) with metabolic dysfunction (MD) were categorized based on alcohol consumption and MD. We also analyzed all-cause, liver-, cancer-, hepatocellular carcinoma (HCC)- and cardiovascular (CV)-related mortalities. Results: This retrospective nationwide cohort study included 1,298,993 individuals aged 40 to 79 years for a mean follow-up duration of 9.04 years. The prevalence of MASLD, MetALD, and ALD with MD was 33.11%, 3.93%, and 1.00%, respectively. Relative to the “no SLD” group, multivariable analysis identified that MASLD (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.26 to 1.31), MetALD (aHR, 1.38; 95% CI, 1.32 to 1.44), and ALD with MD group (aHR, 1.80; 95% CI, 1.68 to 1.93) have a significantly higher risk of all-cause mortality. Furthermore, MASLD, MetALD, ALD with MD groups showed higher liver-, cancer- and HCC-related mortality than “no SLD” group. While all-cause specific mortalities increase from MASLD to MetALD to ALD with MD, the MetALD group shows a lower risk of CV-related mortality compared to MASLD. However, ALD with MD group still have a higher risk of CV-related mortality compared to MASLD. Conclusion SLD is associated with an increased risk of all-cause, liver-, cancer-, HCC-, and CV-related mortalities.

Background: This study compares the association between real-time continuous glucose monitoring (rtCGM) and intermittently- scanned CGM (isCGM) and glycemic control in individuals with type 1 diabetes mellitus (T1DM) in a real-world setting. Methods: Using data from the Korean National Health Insurance Service Cohort, individuals with T1DM managed by intensive insulin therapy were followed at 3-month intervals for 2 years after the initiation of CGM. The glycosylated hemoglobin (HbA1c) levels and coefficients of variation (CVs) of rtCGM and isCGM users were compared using independent two-sample t-test and a linear mixed model. Results: The analyses considered 7,786 individuals (5,875 adults aged ≥19 years and 1,911 children and adolescents aged <19 years). Overall, a significant reduction in HbA1c level was observed after 3 months of CGM, and the effect was sustained for 2 years. The mean HbA1c level at baseline was higher in rtCGM users than in isCGM users (8.9%±2.7% vs. 8.6%±2.2%, P<0.001). However, from 3 to 24 months, rtCGM users had lower HbA1c levels than isCGM users at every time point (7.1%±1.2% vs. 7.5%±1.3% at 24 months, P<0.001 for all time points). In both adults and children, the greater reduction in HbA1c with rtCGM remained significant after adjusting for the baseline characteristics of the users. The CV also showed greater decrease with rtCGM than with isCGM. Conclusion In this large nationwide cohort study, the use of rtCGM was associated with a greater improvement in glycemic control, including HbA1c reduction, than the use of isCGM in both adults and children with T1DM.

Objective: This study compared the incidence of suicide cases among Korean students before and after the coronavirus disease-2019 (COVID-19) pandemic. Methods: Aggregated case reports of all known suicide victims attending elementary, middle, and high school in South Korea from 2017 to 2022 were analyzed. These reports, compiled by teachers under the directive of the South Korean Department of Education, surveyed the circumstances surrounding each suicide and identified associated risk factors posthumously. Results: The completed suicide rate was 2.37 per 100,000 students pre-COVID-19 (2017–2019), significantly increasing to 3.37 per 100,000 students post-COVID-19 (2020–2022; odds ratio [OR] 1.42, p<0.001). The rate began to rise approximately 6 months into the pandemic and continued to worsen throughout 2021 and 2022. Fair attendance significantly increased in 2020 (74.83%, p=0.003) during the initial stage of school closure measures compared to 2019 (58.27%) among students prior to suicide completion. However, as social distancing measures continued, “absence due to medical reasons” showed a significant increase in 2022 (23.56%) compared to 2019 (13.67%, p=0.025) and 2020 (9.52%, p<0.001) among these students. Among those who completed suicide, teachers reported increased signs of depression and anxiety posthumously compared to pre-COVID-19 periods. Conclusion The incidence of completed suicide among students was significantly higher in the post-COVID-19 years compared to pre-COVID-19. Attendance records and teachers’ reports indicated a deterioration in mental health among these students before suicide completion, highlighting the need to consider mental health impacts when implementing future quarantine policies.