Prevalence of Diabetes among Men and Women in China

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102

Aims/IntroductionBesides the aging population in China, the following have become serious public health problems: increasing urban population, lifestyle changes and diabetes. We assessed the epidemiology of type 2 diabetes mellitus in China between 2000 and 2014, and analyzed time trends to better determine the prevalence status of diabetes in China and to provide a basis for prevention and decision‐making.Materials and MethodsIn our systematic review, we searched China National Knowledge Infrastructure, Chinese VIP Information, Wanfang and PubMed databases for studies on type 2 diabetes mellitus between 2000 and 2014 in China. Two investigators extracted the data and assessed the quality of the included literature independently. We excluded studies that did not use 1999 World Health Organization criteria for diabetes. We also excluded reviews and viewpoints, studies with insufficient data, studies that were not carried out in mainland China and studies on troops, community, schools or physical examination people. We used stata 12.0 to combine the prevalence of all studies, calculated the pooled prevalence and its 95% confidence interval, and analyzed the differences among men/women, urban/rural areas and year of study. We calculated the prevalence of seven geographic areas of China, respectively, and mapped the distribution in the whole country to estimate the pooled prevalence of each area.ResultsOur search returned 4,572 studies, 77 of which satisfied the inclusion criteria. The included studies had a total of 1,287,251 participants, in which 680,574 cases of type 2 diabetes mellitus were recorded. The overall prevalence (9.1%) has been increasing since the 1970s, and it increased rapidly with age. The prevalence of the 65–74 years group was as high as 14.1%. Meanwhile, the prevalence among men/women and urban/rural areas was significantly different. The prevalence was 9.9% for men and 11.6% for women, which were significantly higher than the average at the end of the last century and the beginning of this century. The prevalence rate in urban areas (11.4%) was significantly higher than that in rural areas and in urban‐rural fringe areas, and the prevalence in rural areas (8.2%) was slightly higher than that in urban‐rural fringe areas (7.5%). In addition, the prevalence in each geographic area were estimated and mapped, which showed a large imbalance in the map.ConclusionsOur analysis suggested that type 2 diabetes mellitus is highly prevalent in China. These results underscore the urgent need for the government to vigorously strengthen the management of diabetes prevention and control.

Section: Discussionsupporting

confidence: 88%

Prevalence of type 2 diabetes mellitus among inland residents in China (2000–2014): A meta‐analysis

Yang

Shao

Bian

et al. 2016

123

102

“…According to the latest epidemiological study, 11.6% of Chinese adults had diabetes, which accounts for approximately one‐quarter of diabetes patients worldwide, and the percentage for prediabetes was 50.1%2. This is a tremendous change when compared with the data from 20 years ago, when the prevalence of diabetes and impaired glucose tolerance in China were just 2.5% and 3.2%, respectively1, 3. As one of the major risk factors of disabling and life‐threatening complications from microvascular and macrovascular diseases and even cancer4, 5, 6, 7, this chronic disease is now more of a public health challenge than a health issue for individuals.…”

Section: Introductionmentioning

confidence: 98%

“…With a dramatically increased incidence and prevalence, diabetes has become a major public health problem in China1. According to the latest epidemiological study, 11.6% of Chinese adults had diabetes, which accounts for approximately one‐quarter of diabetes patients worldwide, and the percentage for prediabetes was 50.1%2.…”

Section: Introductionmentioning

confidence: 99%

Dietary and physical activity of adult patients with type 2 diabetes in Zhejiang province of eastern China: Data from a cross‐sectional study

Pan

Ming-xia

et al. 2016

Aims/IntroductionLifestyle management helps improve the clinical outcome of patients with type 2 diabetes. The present study aimed to obtain lifestyle data on the dietary and physical activity of adult type 2 diabetes patients in Zhejiang province of eastern China for better patient education and improvement of clinical management.Materials and MethodsA cross‐sectional survey of 607 adult type 2 diabetes patients was carried out in 12 hospitals within eight cities of Zhejiang province. Data were collected for sex, age, basic physical measurement (blood pressure, height, weight, waist circumference and hip circumference), dietary favor and habit (vegetarian diets vs meat diets, preference of salty or light flavors), detailed dietary intake (24‐h recall method), as well as the weekly physical activity.ResultsThe mean age of the patients in the analysis was 56.39 ± 12.29 years, and 38.71% of the patients had higher levels of body mass index than recommended. The average daily total energy intake was 1887.71 ± 575.10 kcal. The percentage of calories from carbohydrate, protein and fat were 61.36 ± 11.59%, 13.29 ± 3.37% and 25.35 ± 11.16%, respectively. For physical activity, the patients generally spent most of their daily time sitting and sleeping, and the time for moderate vigorous activity was limited.ConclusionsAdult patients with type 2 diabetes in Zhejiang province have a relatively high carbohydrate and low protein diet, with very limited physical activity. Patient education to achieve a better lifestyle intervention needs to improve in this region.

“…The data from that study showed that the prevalence of diabetes in Chinese adults was 9.7%, and the rate of increase diabetes prevalence in China especially exceeded the IDF estimation8. In our study, a multistage, stratified sampling method was used to select a nationally representative sample of persons aged 20 years or older in the general population in China and used OGTT as diabetes diagnosis8. The methodology is reliable as it uses a large, well‐constructed sample and the gold standard method for detecting diabetes, the OGTT, as recommended by the World Health Organization, which is more reasonable than just testing fasting blood glucose as other similar studies did in Western countries.…”

mentioning

confidence: 90%

mentioning

confidence: 93%

Epidemic trend of diabetes in China

Chen

Yang

2014

Self Cite

Epidemiology is now well recognized as the foundation of public health. The Da Qing study in 1986 was the first milestone study to show that lifestyle intervention can prevent or delay the onset of diabetes. The lead investigator of that study, Professor Xiaoren Pan, is regarded as the forerunner epidemiologist for diabetes in China and even in Asia. In 2006, study participants were followed up to assess the long‐term effects of the interventions after 20 years. As compared with the control group, those in the combined lifestyle intervention group had a 51% lower incidence of diabetes during the active intervention period and a 43% lower incidence over the 20‐year period, adjusted by age. Recently, the National Diabetes Prevalence Survey in China was carried out from 2007 to 2008. The data from that study showed that the prevalence of diabetes in Chinese adults was 9.7%, and the increased rate of diabetes prevalence in China exceeded the International Diabetes Federation estimation. Very recently, we have reported that acarbose is a viable choice for initial therapy in Chinese patients newly diagnosed with type 2 diabetes who have a lower body mass index and exaggerated postprandial glucose excursion compared with Caucasian patients. We are expecting more contributions from epidemiology to the study of diabetes.