The 'FiftyFifty' lawsuit case that is damaging the future of K-pop.

 Now is truly the golden age of K-pop. Young people from all continents of the world are competitively uploading K-pop cover dances on YouTube, and many are expressing that they have come to know and love Korea through K-pop.

However, recently, a small pebble has been thrown into the progress and love of K-pop. The impact of this pebble is concerning, and it may even lead to a situation where the influence of K-pop, which has been achieved so far, could disappear.

Many people are now worried that the relationship of trust between companies and their idol artists will change into a strict profit-oriented contract focused solely on success and money. The reason is that now, when small and medium-sized entertainment companies diligently train idols and debut them in the world, major conglomerate entertainment companies are ready to swoop in and take away any idols with high potential.

FiftyFifty is an idol group that was dubbed the "miracle of small and medium-sized idols." They were formed by the content-specialized creative group, Attract, with four members (Sena, Aran, Kina, Sio). The team name, FiftyFifty, carries the probabilistic meaning of "half and half," and it also conveys the message that if the group is 50, they hope fans will join as the other 50 to become 100.

When they debuted in November of last year, there was no spotlight on them. This was because they came from an unknown company in the industry, and apart from music show appearances, they had little promotional activity. However, the first response came from overseas. On February 24th this year, they released their first single album 'The Beginning: Cupid.' The title track of the single album, 'Cupid,' gained popularity on short-form content platforms like TikTok, and it reached 8th place on the Billboard World Digital Song Sales Chart. This achievement was made just 110 days after their debut.

Then, on April 1st, they entered the main single chart 'Hot 100.' Within four months of their debut, they made their name on the 'Hot 100,' setting a meaningful record as the K-pop artist with the shortest period of entry. On May 20th (local time), they proudly achieved 17th place on the 'Hot 100,' showcasing extraordinary popularity. Especially on the latest chart released on July 8th, they secured the 24th position on the 'Hot 100,' setting an impressive record of staying on the chart for 15 consecutive weeks. This is the longest record for a K-pop girl group on the 'Hot 100' chart.

However, suddenly a red light was turned on in this trend. On June 23rd, the agency Attract, which had given the members, including Aran, a period of rest after her surgery, announced that they had identified an external force that approached FiftyFifty and induced them to violate their exclusive contract. Attract had been expanding and improving their system to better support artists faithfully. They expressed concerns that this incident could greatly damage the image and future potential of artists who have only debuted a mere 7 months ago and, furthermore, could have serious negative implications for the entire K-pop industry. Attract sent evidence to Warner Music Korea, the overseas distributor of FiftyFifty, accusing them of being behind the "member poaching incident," and demanded an explanation. In response, Warner Music Korea refuted these claims, stating that they were baseless.

However, Warner Music Korea and TheGiverz countered these allegations, calling them "forced framing." TheGiverz side explained that Warner Music Korea had proposed a structure for a "label deal," and they had hoped to discuss this proposal with Attract's CEO, Jeon Hong-joon. They said that it was through this communication that the connection between Attract and Warner Music Korea was established. They also stated that at that time, Jeon Hong-joon had expressed interest in listing Attract and had declined the initial proposal, after which Warner Music Korea modified the offer to suit his preferences.

However, on June 27th, Attract filed a police report against TheGiverz and its CEO, Ahn Sung-il (Stage Name: Cyan), along with three others, for allegedly △ obstructing business △ damaging electronic records △ fraud and embezzlement related to business affairs. Attract also raised concerns about TheGiverz's involvement in the production of FiftyFifty's music, stating that they had given the project to someone else, leading the members to breach their exclusive contract. Additionally, during the process of purchasing the music "Cupid" from an overseas composer, Attract accused TheGiverz and Ahn Sung-il of secretly acquiring the copyright without providing purchase information to Attract. In response, TheGiverz denied being the external force mentioned in the "member poaching incident" and threatened legal action, claiming that Attract was spreading false information.

Amidst all this, the four members of FiftyFifty (Sena, Kina, Aran, Sio) took a stand against their agency, Attract. On June 19th, through the law firm Barun, they filed an application for an injunction to suspend the effect of their exclusive contract with Attract, citing "actions taken by Attract that breached the contract and caused a breakdown of trust." This indicated an impending legal dispute.

On YouTube, FiftyFifty's 'Cupid' surpassed 100 million views. To commemorate this milestone, Attract released a performance music video. However, it was challenging to find celebratory comments on the 'Cupid' official music video and the performance music video that achieved the 100 million views. Instead, comments ranged from supporting Attract's CEO, Jeon Hong-joon, to expressing hopes for the group to be reorganized and make a fresh start.

Observing the current situation of FiftyFifty is truly disheartening. As a group once hailed as the 'girl version of BTS' and potentially capable of propelling K-pop beyond its home base in the United States to sweep the world and elevate Korea's status, it is clear that all those dreams have now vanished. Instead, they are left with a tarnished reputation in the K-pop market, labeled as 'betrayal idols.'

While some may express sympathy, blaming human selfishness and greed for cutting the goose that lays the golden eggs, the criticism towards FiftyFifty members and their families for betraying the agency that supported them and chasing after money incessantly continues.

When success comes at a young age without significant effort, it can lead to arrogance and disregard for others. We have witnessed many cases where individuals who suddenly achieve success, whether through their efforts or not, lose their sense of responsibility, ignore those around them, and chase after personal gains, only to end up falling into ruin.

The old saying that adults used to share is entirely accurate: "As the rice plants mature, they bow their heads." As one's position rises, and as more people show respect and admiration, it becomes essential to live with humility and always respect others. The reason being that a person's status can suddenly plummet to a much lower level than those around them at any given moment.

If one wishes to maintain their position, they must always be humble and show respect to others. Only then can they receive respect from those around them.

The reasons why golf is good for health

 

    Industrialization accelerated, leading to economic prosperity with increased labor efficiency and productivity. However, the quality of people's lives has not improved. This fact emerged from the research of psychologists in the 1960s and 1970s in the United States, who studied the improvement of the quality of life alongside economic growth.

   As individual living standards improved, people had more free time, but there were also increasing issues of drug use, crime, separation of communities and families, and a rise in pollution and mental illness, casting a dark shadow on society.

   In response, many psychologists began studying positive aspects such as happiness, life satisfaction, and subjective well-being as efforts to improve the quality of life. They identified 12 factors, including finance, family relationships, friendships, housing, health, companionship, and religious engagement, that influence life satisfaction.

    To understand happiness and subjective well-being, it is suggested that understanding the supportive relationships people have, their engagement in work and leisure activities, and their personal goals and hopes are better strategies.

   Modern individuals are engaging in various social and cultural activities to enhance their quality of life, and they are increasingly interested in sports activities that benefit their health and happiness.

   According to research by leisure and sports scholars, leisure activities like sports participation lead to higher life satisfaction compared to passive leisure activities.

   In particular, golf can be considered as one of the representative sports in modern times that fits well with people of all ages and genders due to its low physical exertion compared to other sports.

   Golf provides a suitable exercise effect without putting significant strain on the body, while also offering opportunities for social interaction and active interpersonal relationships. Additionally, golf activities can foster respect, etiquette, and voluntary adherence to rules. These advantages contribute to higher levels of leisure satisfaction and overall life satisfaction among golf participants.

    When comparing the preferences for different sports among the general public over the years, golf's popularity has shown a continuous upward trend since 2003. It has emerged as a sport with a preference rate of approximately 7.0%, surpassing other sports such as fitness, hiking, and tennis.

   Furthermore, in 2011, there were 1.68 million screen golf participants and 1.28 million field golf participants, indicating the democratization of golf, as it has shifted from being a sport predominantly for the elite to being accessible to the general public. This trend signifies the increasing activation of golf as a leisure activity, capturing attention and gaining popularity as one of the most noteworthy and active leisure sports, providing both enjoyment and a sense of accomplishment.

   The sudden outbreak of COVID-19 in 2019 shook the world. During this pandemic era, outdoor activities were restricted, leading to many constraints on physical activities indoors. However, golf in the pandemic era was evaluated by four US public health experts as "Risk Level 3," indicating relatively low risk of COVID-19 infection. As a result, it was recommended as a safe leisure activity to participate in, following tennis and jogging.

   Golf, as a leisure sport, allows individuals to enjoy physical exercise in beautiful and clear natural environments. Participating in golf amidst vast scenic locations provides both visual and sensory satisfaction, which can enhance the overall enjoyment of the activity compared to other team sports.

   Golf is not only suitable for meeting the social and psychological needs of modern individuals and relieving everyday stress and tension, but it also incorporates forward-looking elements of sports. With the increase in national income and changing perceptions of sports among the public, interest in self-realization through golf is spreading.

    Nowadays, golf is no longer a sport enjoyed exclusively by certain classes; instead, it has become a sport that anyone from the general public interested in golf can easily participate in.

   In recent times, there has been a growing interest in well-being, leading to an increase in modern individuals seeking happiness and health through sports. This trend is because, for humans, it has become an integral part of life to enjoy better styles and leisure activities and enhance their quality of life through a cultural emphasis on pursuing well-being.

   The importance of health in the current era needs no further explanation, as everyone strives to maintain and pursue physical, emotional, and mental well-being through physical activity. Human beings are instinctively inclined to move, and physical activity is a fundamental means of sustaining and preserving life.

Here are 12 positive effects that exercise brings

    It has long been believed that intense physical activity has positive effects on health. However, in modern times, it has been proven that moderate physical exercise reduces mortality rates. Simply walking for 30 to 45 minutes, 5 to 6 days a week, can increase average lifespan. Furthermore, the benefits of exercise are diverse.

   In particular, physical activity is highly effective in preventing diseases and promoting overall health. Regular exercise keeps the heart, blood vessels, lungs, bones, muscles, and joints healthy. Engaging in various recreational sports activities such as jogging, aerobics, walking, golf, and swimming naturally improves physical, mental, and social well-being.

   While there may be cases where individuals with certain illnesses should avoid exercise, in most cases, exercise has a positive impact on health promotion. Additionally, exercise stimulates the physiological activation of the brain and increases the arousal of the sympathetic nervous system. It also has a purifying effect, washing away aggressiveness and anger.

1. Physical Effects of Exercise

  a) Prevention of cardiovascular diseases

   Engaging in regular exercise strengthens the heart. For example, the heart muscle enlarges and the muscle fibers thicken, allowing it to supply more blood during exercise. Cardiac output, which refers to the amount of blood expelled with each contraction of the heart, increases with more exercise, effectively preventing heart diseases.

  b) Decreased incidence of adult-onset diseases and improved cardiac (pulmonary) function 

   Adult-onset diseases include various circulatory disorders such as atherosclerosis, hypertension, rheumatic heart disease, and other conditions affecting organs, tissues, blood vessels, and the heart. In Korea, adult-onset diseases include symptoms related to diabetes, cardiac arrest, and stroke.

   Most adult-onset diseases occur due to obesity and the accumulation of harmful substances in the body. By maintaining appropriate body weight and engaging in regular exercise to eliminate toxins, adult-onset diseases can be prevented. Regular exercise increases lung capacity, respiratory rate, and air passage through bronchial dilation, thereby enhancing pulmonary function.

  c) Reduction of body fat and prevention of obesity

   Continuing exercise along with a balanced diet helps reduce excessive weight and maintain a healthy weight. Exercise requires more energy than usual, resulting in the utilization of stored fat and subsequent weight loss. Exercise not only helps prevent obesity but also promotes muscle development. As muscles replace the weight of reduced fat, they become more toned, resulting in a more aesthetically pleasing body. Regular exercise helps control weight and prevents obesity.

  d) Strengthening of muscles and prevention of osteoporosis 

   Regular exercise increases lung capacity and muscle strength, improving overall bodily functions. Muscle strength refers to the ability to sustain force, and exercise increases the supply of minerals and calcium to strengthen bones. Vigorous weight-bearing exercises reduce the risk of osteoporosis, particularly after old age. Post-menopausal women are prone to osteoporosis, making exercise essential for prevention.

  e) Increase in basal metabolic rate

   Basal metabolic rate refers to the minimum energy required for biological functions to sustain life. Exercise increases muscle mass and subsequently raises the basal metabolic rate, facilitating easier weight control by utilizing excess energy from food intake.

  f) Maintenance of good posture

   Exercise strengthens the abdominal muscles, reduces fat, and helps maintain good posture. It also strengthens the abdominal muscles, facilitating proper posture and reducing back pain.

2. Mental and Emotional Effects

  a) Stress reduction

   Physical and mental stress can have a significant negative impact on each other. Mental stress affects the body, leading to physical fatigue. Engaging in exercise helps relieve fatigue and reduce stress. Stress is the root of many diseases and can cause muscle tension, pain, anger, insomnia, abdominal pain, urinary disorders, and more. Stress also creates a vicious cycle between the body and mind. However, exercise triggers the release of endorphins in the brain, relaxing the muscles and helping to alleviate stress.

  b) Alleviation of depression

   Regular exercise can regulate anxiety, depression, and anger in the short term, leading to feelings of happiness. It also boosts self-confidence and triggers the release of endorphins in the brain, creating a sense of pleasure. Psychologist Roger Walsh described exercise as the most cost-effective and side-effect-free treatment for mental health.

c) Enhancement of self-esteem

   Regular exercise improves physical fitness and exercise abilities, enabling individuals to lead emotionally and mentally healthy lives while maintaining a good physique. It also has a positive effect on appearance, leading to increased self-confidence. The positive effects on appearance act as an achievement experience, enhancing self-esteem.

   Exercise has positive effects on one's talents, personality, health, and appearance. Non-aerobic exercise has more beneficial effects than aerobic exercise.

  d) Promotion of sound sleep and prevention of insomnia

   Regular exercise improves the quality of sleep and helps with stress relief. Engaging in exercise about one hour before bedtime can prevent insomnia. Sound sleep enhances the quality of life.

3. Social Effects

  a) Social Effects

   Engaging in exercise allows individuals to connect and communicate with new people. Through this, relationships are formed, and individuals can comfortably exercise with familiar people. Exercising together naturally fosters a sense of closeness and helps maintain interpersonal relationships.

  b) Social development

Exercising together allows individuals to develop social skills through competition and teamwork. It helps cultivate empathy towards others and the ability to engage in healthy competition within social groups or organizations.

c) Strengthening community consciousness

Exercising together fosters a sense of belonging, enabling regular participation in exercise and promoting a sense of community. It allows individuals to experience a sense of community consciousness through exercise.

Treatment Methods and Complications of Diabetes

 Concept of Diabetes

   Diabetes is a chronic condition that is difficult to cure, characterized by hyperglycemia and glycosuria caused by absolute or relative deficiency of insulin. Diabetes is classified into multiple types based on specific causes that lead to insulin deficiency. One type is called insulin-independent diabetes, which is characterized by relative insulin deficiency due to beta-cell defects in the pancreas or increased insulin demand in the body.

   Insulin-independent diabetes accounts for the majority of diabetes cases in Koreans and is the most common form among various types of diabetes. Approximately 85-90% of these cases occur primarily after the age of 40.

   The major pathological mechanisms of insulin-independent diabetes can be explained by impaired insulin secretion function in the pancreas and insulin resistance. In insulin-independent diabetes, the quantity and activity of beta cells in the pancreas are similar to those in normal individuals, but the amount of insulin secreted after stimulation by beta cells is lower compared to normal individuals. This indicates decreased insulin secretion function in the pancreas. The phenomenon where the serum insulin level in patients is normal or increased reflects reduced sensitivity to insulin, indicating impaired insulin receptor function or insulin-resistant characteristics due to defects in intracellular processes after receptor binding.

Insulin

   Insulin is produced by clusters of cells called beta cells in our pancreas, and it helps us utilize glucose from the food we eat. In order for blood glucose to be transported into cells, insulin's assistance is required. It functions like a key that opens insulin receptors, which are present on cell membranes, allowing glucose to enter the cells. The occurrence of diabetes is mostly associated with absolute or relative deficiency of insulin, and the treatment of diabetes is directly or indirectly related to insulin.

   Insulin is administered to patients with type 1 diabetes or childhood-onset diabetes who have impaired insulin secretion in the pancreas. It is also used in cases where dietary control does not effectively regulate blood glucose during pregnancy in diabetic patients, when oral hypoglycemic agents are ineffective for blood glucose control in adult-onset diabetes, during major surgeries, or in cases of hyperglycemic coma.

Blood Glucose

   Blood glucose refers to the glucose supplied from the food we consume, serving as a source of energy within the body. In healthy individuals, after a meal, blood glucose levels increase, and insulin is secreted by the pancreas in response. The secreted insulin transports glucose from the bloodstream into cells, where it is utilized as energy. In diabetic patients, insufficient insulin secretion or impaired insulin function leads to elevated blood glucose levels. Normal fasting blood glucose levels are below 115 mg/dL, and 2 hours after a meal, it should be below 140 mg/dL.

Glycated Hemoglobin

  Within human red blood cells, there is a protein called hemoglobin, which is necessary for oxygen transport and is referred to as hemoglobin A1c (HbA1c). When blood glucose (glycemia) rises, a portion of glucose binds to hemoglobin. This glucose-bound hemoglobin is called glycated hemoglobin or HbA1c.

   The lifespan of red blood cells is approximately 120 days. In our bodies, some red blood cells break down daily, while new ones are produced, maintaining a constant level. However, once glucose is bound and glycated hemoglobin is formed, the red blood cell retains glycated hemoglobin until it reaches the end of its lifespan. Prolonged high blood glucose levels lead to an increase in glycated hemoglobin within red blood cells.

   While blood glucose tests determine the amount of glucose present in the blood on a daily basis, glycated hemoglobin reflects the average blood glucose level over an 8-week period. Glycated hemoglobin provides an indication of how well diabetes has been controlled over the past few months. The normal range for glycated hemoglobin is less than 6%.

Treatment Methods for Diabetes

   Since diabetes is a chronic condition with progressive advancement, consistent and continuous treatment is crucial. Failure to manage diabetes effectively can lead to various acute and chronic complications, making proper blood glucose control essential. To achieve efficient blood glucose management, medication therapy, dietary therapy, and exercise therapy are available, and appropriate treatment methods should be selected and adjusted based on individual symptoms. However, recent research suggests that diabetes knowledge, a positive attitude, family support, and stress management are also important.

Medication Therapy

   The choice between oral hypoglycemic agents and insulin injections depends on the mechanism and cause of diabetes and the ability to produce insulin. Oral hypoglycemic agents are commonly used when dietary therapy alone is insufficient for diabetes management. These agents facilitate insulin secretion from the pancreas, thereby reducing blood glucose levels. Insulin injections, derived from animal pancreases such as pigs, are used when dietary therapy and oral medications do not sufficiently regulate blood glucose levels. The dosage of insulin depends on the type of insulin, its duration of action and peak effect time, the patient's condition, dietary habits, and blood glucose levels.

Dietary Therapy

   Dietary therapy is essential for individuals with diabetes because it enables the intake and digestion of appropriate energy sources necessary for maintaining health. In order to maintain ideal body weight, diabetic patients need to determine the calorie intake of the required food. Typically, the method of determining ideal body weight is proportional to height. Subtracting 100 from one's height and taking 90% of that value gives an estimate of ideal body weight. Once ideal body weight is measured in this manner, the necessary calorie intake for the corresponding weight should be calculated to obtain an appropriate amount of energy.

   Dietary therapy for diabetes does not involve rigid food restrictions or prohibitions, but rather adjusting the amount, type, and timing of food intake according to individual requirements. The goal of dietary therapy for diabetes is to suppress blood glucose elevation as much as possible. It aims to maintain appropriate blood glucose and lipid levels, balance insulin levels, sustain desirable body weight, and promote overall nutritional well-being.

Exercise Therapy

   Exercise therapy is recognized as one of the most effective methods, along with dietary therapy, for managing diabetes. Exercise not only prevents aging of blood vessels and muscles but also promotes active glucose metabolism, especially in muscles, leading to a decrease in blood glucose levels. It also enhances the action of insulin and plays a significant role in preventing obesity. Exercise for diabetic patients does not refer to specific sports or exercises but rather physical activities in daily life, such as household chores, yard work, or walking. It encompasses any bodily movement or labor, and even activities like walking or doing housework can be considered exercise.

   However, diabetic patients have abnormalities in various metabolic processes due to inadequate insulin secretion from the pancreas, so intense exercise can cause excessive lowering of blood glucose levels, resulting in hypoglycemic symptoms. Therefore, diabetic patients should engage in regular, moderate exercise suitable for their daily routine, rather than intense or partial exercises.

Complications of Diabetes

   Complications caused by diabetes are more distressing to patients and can decrease their average lifespan compared to the disease itself. Diabetic complications are diverse, difficult to treat, and often associated with the duration of diabetes and blood glucose levels.

   Diabetic complications can be categorized into acute and chronic complications. Acute complications occur due to excessively high or low blood glucose levels. Examples of acute complications include hyperglycemic coma, ketoacidosis, and hypoglycemia. Chronic complications affect various parts of the body and include cardiovascular diseases, kidney diseases, eye diseases, skin diseases, and oral diseases. Once chronic complications occur, they are difficult to treat, so prevention is crucial. Even if complications have already developed, maintaining normal blood glucose levels can slow down the progression of complications.

The Impact of Life Stress on Diabetes

 

  As living standards improve and science advances in the modern era, the extension of human lifespan has led to a clear shift from acute to chronic diseases. Among chronic diseases, diabetes is known to be sensitive to the socioeconomic status of a country, as it reflects changes in disease prevalence rates.

  Furthermore, as society develops and lifestyles become more westernized, the prevalence of diabetes is increasing. In South Korea, with rapid economic growth and westernization over the past 30 years, the estimated prevalence rate of diabetes, which was less than 1% in the 1970s, increased to approximately 3% in the 1980s. In the 1990s, reports indicated prevalence rates exceeding 3% and ranging from 5-8% in certain regions.

  Diabetes, as the name suggests, is a disease in which glucose is excreted in urine. In normal cases, most ingested food is converted to glucose, and the blood carries this glucose to the body's cells. However, in diabetes, insulin (a hormone) is either not produced properly or does not function correctly, preventing glucose from entering the cells.

  In other words, diabetes is a chronic metabolic disorder characterized by chronic hyperglycemia and its accompanying complications. If efficient blood sugar control is not achieved, the complications associated with diabetes make it difficult to maintain a good quality of life. Due to the burden of managing blood sugar, diabetes has the potential to significantly impair a person's life more than other diseases.

  As chronic diseases often focus on controlling disease progression rather than complete recovery, lifelong treatment and management are essential. The principles of diabetes treatment include dietary therapy, exercise therapy, and medication. However, in cases where stress is considered to contribute to the onset or worsening of diabetes, stress relief can aid in blood sugar regulation.

  Recent studies have reported that over 80% of all diseases are related to stress. High-stress life events are associated with individuals' physical dysfunction and psychological adaptability. With society undergoing rapid and increasingly complex changes and growing uncertainty about the future, modern individuals experience more stress than ever before. Stress has become an integral part of life in contemporary society, to the extent that it is considered to be part of life from birth to death.

  Stress can be categorized into physical stress, such as chronic diseases, infections, surgery, trauma, and famine, and psychological stress, such as high anxiety or a state of tension. Although the detailed mechanisms by which stress affects the body have not been clearly established, stress is initially recognized in the central nervous system and then influences various organs in the body through the endocrine or autonomic nervous system.

  Diabetes is no exception, as stress has long been recognized as one of the causes of diabetes. Since the early 20th century, as experimental research replaced medical research based on clinical observations, efforts have been made to investigate the relationship between diabetes and stress through experimental studies. Research has revealed that stress not only promotes the onset of diabetes but also worsens blood sugar control in diagnosed diabetic patients.

  Recent research presentations on diabetes and stress show that individuals with type 1 diabetes have experienced significantly more severe stress events within three years prior to diagnosis compared to non-diabetic individuals. Additionally, for individuals with insulin-dependent diabetes, stress factors do not affect stress perception but do influence the onset and exacerbation of the disease.

  Numerous studies emphasize the importance of stress in diabetes and suggest that experiences of stress or stress perception have a significant impact on diabetes patients. Regarding stress and diabetes management in diabetes patients, it is argued that the quantity of stress is not the crucial factor, but rather the patient's ability to adapt to stress determines the different manifestations of crises in daily life. Therefore, how patients perceive and cope with stress is more important.

  In the future, efforts will continue to investigate the impact of stress on blood sugar management in diabetes patients and to determine the most appropriate coping strategies for stress. I hope that my writings can be helpful to many people with diabetes and their families who are struggling with diabetes.

Diabetes and depression in the elderly

1. Causes of Depression in the Elderly

  Various factors contribute to the occurrence of depression in the elderly, including sociodemographic factors, economic factors, and physical health conditions. Among these factors, it has been found that the presence of chronic diseases is closely related to depression. The incidence of depression is higher in elderly individuals with chronic illnesses, and if proper treatment is not provided when depression occurs in these individuals, it can worsen the symptoms of depression. Conversely, the worsening of depression can also have a negative impact on the treatment progress of physical illnesses.

2. Diabetes and Depression

  Diabetes is one of the major diseases with a significant burden in South Korea. From 2008 to 2018, it ranked first in the disease burden for a period of 10 years. Pharmaceutical companies worldwide are continuously developing effective drugs for diabetes treatment. In recent years, clinical trials for the development of combination therapies involving three diabetes medications have been conducted in South Korea, and the development of new drugs for these indications is also underway.

  If diabetes is not properly treated, it can lead to complications such as cardiovascular diseases, neuropathy, nephropathy, and retinopathy. In addition to these complications, depression can also occur. Although depression is relatively less recognized compared to other diabetes complications, diabetes is a disease that has a significant psychological impact in terms of onset and disease progression. Diabetic patients often experience various negative psychological changes, which increase the risk of developing depression.

3. Definition of Depression

  Depression is a common mental disorder characterized by symptoms such as sadness, loss of interest or pleasure, guilt, low self-esteem, sleep or appetite disturbances, fatigue, and impaired concentration. Depression has been reported to affect over 300 million people worldwide. The World Health Organization (WHO) has identified depression as a leading cause of disability and predicted that it will be the most burdensome disease for humanity by 2030.

4. Current Status of Depression in South Korea

  Looking at the current status of depression in South Korea, the number of depression patients has increased by 35.1% (annual average of 7.8%) from 2017 to 2021, with 931,481 patients in 2021 compared to 691,164 patients in 2017. In 2017, patients in their 60s accounted for the largest proportion of total depression patients at 18.7%, but in 2021, patients in their 20s were the largest group at 19.0%.

5. Screening and Diagnosis of Depression

  If there are depressive symptoms, it is important to use validated and reliable screening tests to assess the presence of depression. There are various types of depression screening tests available, and the Korean National Health and Nutrition Examination Survey uses the PHQ-9 for depression screening. The CES-D, a 20-item tool developed by Radloff in 1977, measures the level of depressive symptoms based on the frequency experienced over the past week, and a score of 16 is used as the cutoff point internationally, while 21 is used in South Korea for diagnosis.

6. Relationship between Diabetes and Depression

  Diabetes is a disease that arises from problems with insulin secretion, which regulates blood glucose levels. It is classified into type 1 diabetes, where the beta cells of the pancreas gradually get destroyed, resulting in a lack of insulin secretion, and type 2 diabetes, which is caused by insulin resistance (reduced effectiveness of insulin) and insufficient insulin secretion. In South Korea, diabetes had the highest disease burden rate for a period of 10 years, and as of 2020, the number of diabetes patients aged 30 and above in South Korea was approximately 6 million, surpassing the predicted number of diabetes patients by the Korean Diabetes Association for the year 2050. Diabetes is known to be a disease with a high risk of developing complications such as cardiovascular diseases, neuropathy, nephropathy, and retinopathy, and depression is one of them.

  Depression is known to be the most common psychiatric disorder among diabetes patients and is reported to be twice as high compared to patients without diabetes. The Ministry of Health and Welfare has published guidelines for psychological support for diabetes, stating that depression exacerbates the symptoms of diabetes, reduces treatment compliance, adversely affects blood glucose control, and increases the risk of progression of peripheral organ damage.

  The mechanisms by which diabetes triggers depression have not been clearly elucidated yet, but it is believed to result from complex interactions of psychological, physical, and genetic factors. Hypotheses explaining the relationship include increased stress due to the intensity and repetitiveness of diabetes treatment, prolonged duration of diabetes leading to increased burden from other comorbidities and complications, and decreased quality of life. Furthermore, as diabetes and depression are both metabolic disorders, there is mention of their association, and some Mendelian randomization studies have found single-nucleotide polymorphisms known to contribute to diabetes as predictive variables for distress, interpersonal relationships, temperament, and other depressive symptoms, suggesting a link between diabetes and depression.

  Studies have shown that in individuals with diabetes, females, those aged 75 and above, those with a high school education or below, those who do not engage in regular exercise, or those living alone have higher depression scores compared to individuals without diabetes. According to the guidelines for psychological support for diabetes published by the designated Type 2 Diabetes Clinical Research Center of the Ministry of Health and Welfare, the onset of diabetes can be a crisis for many people. Emotionally challenging times can be accompanied by clinically evident or latent emotional problems, and pre-existing emotional issues can worsen.

  In addition, severe mental disorders such as major depressive disorder or anxiety disorder can occur after the diagnosis of diabetes. If depression occurs in patients with diabetes, it can increase the risk of conditions such as stroke and cardiovascular disease, so it is important to consider both physical aspects and provide emotional support.

  Therefore, more attention and affection from families are needed to prevent depression in patients with diabetes. Thank you for your attention.