A large population-based study of diabetes in China conducted by investigators from Tulane University and their colleagues in China has concluded that the disease has reached epidemic proportions in the adult population of China. The study estimates that 92.4 million adults age 20 or older (9.7 percent of the population) have diabetes and 148.2 million adults (15.5 percent) have prediabetes, a key risk factor for the development of overt diabetes and cardiovascular disease. The results are published in the March 25 edition of The New England Journal of Medicine.
The study builds on several recent large studies in China that have documented a rapid increase in diabetes in the population. The current study administered an oral glucose tolerance test to 46,239 adults aged 20 or older from 14 provinces and municipalities throughout China in order to identify cases of previously undiagnosed diabetes. Subjects of the study who had been previously diagnosed with diabetes were identified through questioning by the study's data collectors.
Following recent rapid economic development in China, cardiovascular disease has become the leading cause of death in the county. Diabetes is a major risk factor for cardiovascular disease, and the prevalence of diabetes in China, as this study indicates, is high and increasing. Diabetes increases the risk of cardiovascular complications and premature death, and results in a massive economic burden for society.
The researchers noted a higher prevalence of diabetes among urban residents in China than among rural ones, a result consistent with observations that have been made in developing countries throughout the world. "Urbanization is associated with changes in lifestyle that lead to physical inactivity, an unhealthful diet and obesity, all of which have been implicated as contributing factors in the development of diabetes," says Dr. Jiang He, Joseph S. Copes, M.D. Chair and Professor, Department of Epidemiology, Tulane University School of Public health and Tropical Medicine and the senior author of the study.
With its very large population, China may bear a higher diabetes-related burden than any other country, assert the researchers. Especially alarming is the finding that the majority of cases of diabetes (60.7 percent) are undiagnosed and untreated. The researchers conclude that diabetes and its consequences have become a major public health crisis in China, and recommend that the country quickly develop and institute national strategies for preventing, detecting and treating diabetes in the general population.