The reporter learned from Xi'an Jiaotong University that the team of Professor Wang Youfa of the Global Health Research Institute and the School of Public Health of the University and Professor Wu Jing of the Center for Chronic Noncommunicable Disease Prevention and Control of the Chinese Center for Disease Control and Prevention, Professor Wang Limin, Professor Peng Wen of Qinghai University, Professor Shi Zumin of Qatar University, etc. cooperated to carry out research, and found that the prevalence of diabetes in China increased significantly during 2013-2018, 12.4% of adults in China had diabetes, 38.1% had pre-diabetes, the awareness rate, Treatment and control rates remain at low levels overall. At the same time, factors such as the high rate of overweight and obesity and poor lifestyle in China will continue to increase the burden of diabetes and its complications in China. The study, titled "Diabetes Epidemic and Treatment in China from 2013 to 2018", was published in the Journal of the American Medical Association, an international authoritative medical journal, on December 28, which has important clinical and public health significance. The co-first authors of the paper are Wang Limin of the Center for Chronic Diseases of the Chinese Center for Disease Control and Prevention, Peng Wen of Qinghai University, and Zhao Zhenping of the Center for Chronic Diseases. The co-corresponding authors are Professor Wu Jing, Director of the Center for Chronic Diseases of the Chinese Center for Disease Control and Prevention, and Professor Wang Youfa, leading scholar of Xi'an Jiaotong University and dean of the Institute of Global Health.
Based on the monitoring data of chronic diseases and risk factors in China in recent years, the study analyzed the data collected from 343,929 study subjects in 2013-2014 and 2018-2019. Studies have shown that between 2013 and 2018, the prevalence of diabetes increased from 10.9% to 12.4%, and the prevalence of prediabetes increased from 35.7% to 38.1%. In 2018, only about 1/3 (36.7%) of people with diabetes knew about the disease, nearly 1/3 (32.9%) had been treated, and about 1/2 (50.1%) of those treated with diabetes had their blood glucose levels controlled. Between 2013 and 2018, the awareness rate and treatment rate of women were significantly higher than that of men; the awareness rate, treatment rate and control rate of the treatment of rural residents were improved.
Between 2013 and 2018, the risk factors for diabetes studied did not improve significantly, and some risk factors even worse, such as the proportion of excessive red meat intake increased from 32.6% to 42.3%, and the proportion of physical inactivity increased from 16.0% to 22.0%. The obesity rate has also increased, according to China's body mass index (BMI) standard, the prevalence of obesity (BMI≥28 kg/m2) increased from 14.1% to 16.5% during the period; central obesity increased from 31.6% to 35.4%. In 2018, half of adults were overweight or obese (BMI≥24 kg/m2).
This finding has important clinical and public health implications. China needs to further improve the government-led, multi-departmental coordination, and the participation of the whole society in the prevention and control mechanism of chronic diseases, take comprehensive actions to control risk factors, strengthen screening, and carry out early intervention for pre-diabetic populations, which can curb or slow down the occurrence of diabetes; strengthen the management of diabetic patients, especially to improve the level of chronic disease management in rural grass-roots health service institutions, and adopt precise prevention and control measures for special groups such as men and the elderly to help achieve the goals of the "Healthy China 2030" action.
In addition, in order to solve the increasing burden of chronic diseases such as diabetes, China needs to carry out more relevant scientific research, develop appropriate technologies and achievements for the control of diabetes and related risk factors, comprehensively and targetedly intervene in risk factors and strengthen the management of diabetic patients, and regularly and comprehensively evaluate the "Healthy China" action plan and related policies to help more effectively carry out the prevention and control of chronic diseases in the future. My country's experience will also help to inform other countries, particularly those in socio-economic transition.
Table 1. Weighted awareness, treatment rates, and treatment control rates for adult diabetes with different characteristics (sex, age, place of residence, and region) in China, 2013-2014 and 2018-2019 [%, 95% confidence interval (CI)]
Awareness rate: The proportion of people diagnosed with diabetes who have been identified as diabetes in all people with diabetes. Treatment rate: Proportion of all people with diabetes who have received measures such as insulin, diabetes medications, dietary control, and/or increased activity to control blood sugar. Treatment control rate: The proportion of diabetics who have met the blood glucose level (HbA1c level ol) by treatment account for the proportion of diabetics who have been treated.
Table 2. Prevalence of risk factors among adults in China, 2013-2014 and 2018-2019 [%, 95% confidence interval (CI)]
Risk factors
2018
2013
Absolute percentage increase
Overweight/obesity (BMI≥24 kg/m2)
51.0 (50.0-52.1)
46.6 (45.4-47.8)
4.5 (3.0-5.9)
Obesity (BMI≥28 kg/m2)
16.5 (15.9-17.1)
14.1 (13.5-14.8)
2.4 (1.5-3.2)
Central obesity (waist circumference: male ≥ 90cm, female ≥85cm)
35.4 (34.3-36.5)
31.6 (30.5-32.8)
3.8 (2.3-5.2)
Now smoke
26.0 (25.1-26.9)
27.5 (26.7-28.2)
-1.5 (-2.6--0.4)
Excessive alcohol consumption (15 g/day for women ≥, 25 g/day for men ≥)
8.2 (7.6-8.8)
9.3 (8.8-9.8)
-1.1 (-1.8--0.4)
Low-intensity physical activity (