China has overtaken India as the global epicenter of the diabetes epidemic after a study showed twice as many Chinese are afflicted with the disease as previously estimated.

Type-2 diabetes, mostly caused by a high-calorie diet and sedentary lifestyle, afflicts 92.4 million adults in China, a study published yesterday in the New England Journal of Medicine found. Earlier surveys calculated 43.2 million diabetics in the country, fewer than the 50.8 million that the Brussels-based International Diabetes Federation estimates are in India.

“This shows that the global burden of diabetes is far larger than previously estimated,” David Whiting, a disease tracker with the federation, said in a statement. “It is a wake-up call for governments and policy-makers to take action on diabetes.”

More than half of China’s diabetics haven’t been diagnosed, the study’s authors said. That stands in the way of treatment for a disease that increases the risk of dying from stroke and heart attack, and reflects an unwanted consequence of the country’s economic development and rapid urbanization. China will lose $558 billion of national income to diabetes and heart disease between 2005 and 2015, the World Health Organization and World Economic Forum said in a 2008 report.

“The aging of the population, urbanization, nutritional changes, and decreasing levels of physical activity, with a consequent epidemic of obesity, have probably contributed to the rapid increase in the diabetes burden in the Chinese population,” Yang Wenying, head of endocrinology at the China- Japan Friendship Hospital in Beijing, and colleagues wrote.

There are about 26.8 million diabetics in the U.S., or about 12.3 percent of the population, according to the IDF. The prevalence is about 7.1 percent in India and 4.5 percent in China, the federation says.

Risk of Illness

Yang and researchers from more than a dozen Chinese hospitals analyzed data collected in 2007 and 2008 from 46,239 adults at least 20 years old to determine the prevalence of diabetes and to identify those at risk of the illness. The scientists estimated that an additional 148.2 million people have higher-than-normal blood glucose levels, which put them in a pre-diabetic state.

The diagnosis was made using two different measurements of blood sugar levels. One involved taking measurements after the patients had fasted for a period of time and the other evaluated the amount of sugar in the blood two hours after the patients had consumed a sweet drink. The latter test wasn’t universally applied in previous surveys, which may have meant the true prevalence of diabetes in China was underestimated, Yang and colleagues wrote.

Diabetes was almost 1.4 times more common among city dwellers than rural residents, the study showed.

Major Challenge

“These results indicate that diabetes has become a major public health challenge in China and underscore the need for national strategies aimed at the prevention, detection, and treatment of diabetes in the Chinese population,” the authors wrote.

China’s government should find ways to help people be more physically active and improve their diets, the IDF’s Whiting said.

“As China goes through rapid economic expansion and urbanization, its disease spectrum development is similar to what we saw in Europe and the U.S.,” Zhong Nanshan, president of the Chinese Medical Association, told reporters at China’s national congress this month. “We need to start from trying to change people’s lifestyle. The lack of health care staff per capita is also an obstacle to improving the disease prevention situation,” he said.

-With assistance from Yidi Zhao in Beijing and Simeon Bennett in Singapore. Editors: Carey Sargent, Angela Cullen

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By Jason Gale

March 25 (Bloomberg)