March 24, 2010 http://www.physorg.com/news188669852.html
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.
Provided by Tulane University
N Engl J Med. 2010 Mar 25;362(12):1090-101.
China-Japan Friendship Hospital, Beijing, China. ywy_1010 at yahoo.com.cn
BACKGROUND: Because of the rapid change in lifestyle in China, there is concern that diabetes may become epidemic. We conducted a national study from June 2007 through May 2008 to estimate the prevalence of diabetes among Chinese adults.
METHODS: A nationally representative sample of 46,239 adults, 20 years of age or older, from 14 provinces and municipalities participated in the study. After an overnight fast, participants underwent an oral glucose-tolerance test, and fasting and 2-hour glucose levels were measured to identify undiagnosed diabetes and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance). Previously diagnosed diabetes was determined on the basis of self-report.
RESULTS: The age-standardized prevalences of total diabetes (which included both previously diagnosed diabetes and previously undiagnosed diabetes) and prediabetes were 9.7% (10.6% among men and 8.8% among women) and 15.5% (16.1% among men and 14.9% among women), respectively, accounting for 92.4 million adults with diabetes (50.2 million men and 42.2 million women) and 148.2 million adults with prediabetes (76.1 million men and 72.1 million women). The prevalence of diabetes increased with increasing age (3.2%, 11.5%, and 20.4% among persons who were 20 to 39, 40 to 59, and > or = 60 years of age, respectively) and with increasing weight (4.5%, 7.6%, 12.8%, and 18.5% among persons with a body-mass index the weight in kilograms divided by the square of the height in meters of < 18.5, 18.5 to 24.9, 25.0 to 29.9, and > or = 30.0, respectively). The prevalence of diabetes was higher among urban residents than among rural residents (11.4% vs. 8.2%). The prevalence of isolated impaired glucose tolerance was higher than that of isolated impaired fasting glucose (11.0% vs. 3.2% among men and 10.9% vs. 2.2% among women).
CONCLUSIONS: These results indicate that diabetes has become a major public health problem in China and that strategies aimed at the prevention and treatment of diabetes are needed. 2010 Massachusetts Medical Society PMID: 20335585