Five-Year Trajectory about Screening for Complication of Diabetic Kidney Disease and Cardiovascular Disease Mortality: Focusing on Regional Difference

Abstract

Introduction: The overall screening rate for complication of diabetic kidney disease is improving; however, regional variations are increasing. It is necessary to identify regions vulnerable to change and understand their characteristics. Methods: Group-based trajectory analysis was used to derive patterns of change in screening rate for complication of diabetic kidney disease in 244 regions, utilizing data from the Korea Community Health Survey between 2015 and 2019. An analysis of variance test was used to examine the differences in regional characteristics and cardiovascular disease (CVD) within each change pattern. Results: The change patterns in screening rates for complication of diabetic kidney disease were classified into four groups: high and rapidly increasing (group 1, 15.2%), steady high (group 2, 8.2%), moderate and increasing (group 3, 52.9%), and low and slightly increasing (group 4, 23.8%). Group 4 had many rural areas and worse socioeconomic status, health care systems, health behaviors, and diabetes management. These regions exhibited higher CVD mortality rates. Conclusions: Regions where the screening rate for complication of diabetic kidney disease did not improve compared to other regions were vulnerable not only in socioeconomic status, health care system, and health behavior, but also in disease management. This suggests the need for local and environmental support, as well as aggressive health service interventions in relatively vulnerable areas.