Diabetes continuing to spike in China

REASONS FOR INCREASE UNCLEAR

In 2010 China surged to the head of the pack in terms of countries with the most diabetic residents, with 92 million in 2010 (see Reuters Health report of March 24, 2010).

The study did not pinpoint the causes of the rise in diabetes, and Koplan said he could only speculate on what’s to blame.

He said that it’s been well documented that people are getting wealthier and heavier in China and diets are including more saturated fat.

Level of public awareness of diabetes in China

Around the world, there are many people with diabetes who remain undiagnosed. In some poorer countries, 80% to 90% of people with diabetes are undiagnosed; while even in high-income countries 30% may be undiagnosed.

In China, 60.7% are undiagnosed, and this is likely to result from the combination of poor public awareness and limited opportunities for diagnosis.

People often have type 2 diabetes for a long time before it is diagnosed. For many people, the diagnosis comes when they make contact with the health system for other reasons (for example when admitted to hospital with a heart attack). The longer people are undiagnosed, the more likely it is that their blood glucose will be poorly controlled and therefore their risk of developing diabetes complications, that can affect their sight, kidneys or lead to amputations or stroke, will be higher.

In China, there is room to increase the proportion of people who are diagnosed, but this needs to be backed up with sufficient resources to manage and treat larger numbers of people with diabetes. Diagnosing more cases without being able to increase the amount of care available will do little to improve the lives of people with diabetes.

He also said people are becoming more dependent on cars and less inclined to walk or ride a bike.

“All these factors would help contribute to having an increased prevalence in type 2 diabetes,” said Koplan, who did not participate in the research.

The authors write in their study that an aging population in China likely explains some of their findings.

The discovery of diabetes happened in the first century B.C. and before. This disease was remarked upon by both Greek physicians during this time as well as Indian physicians, and in Japan, China, and Korea it is also known as the “sweet urine disease”. This was because the easiest method of identification was by noticing that the urine of affected people contained extra amounts of sugar. In fact, early physicians noted that ants were likely to come to the place where a person with diabetes had urinated to collect the sugar there.

Older people are more likely to develop type 2 diabetes, and the researchers note that 20 percent of Shanghai residents are over age 60, with that proportion increasing.

Koplan said many countries have programs to promote healthy lifestyles and prevent type 2 diabetes, but as of yet there’s “not a proven documented intervention that can reverse this epidemic of obesity and epidemic of type 2 diabetes.”

SOURCE: Diabetes Care, online March 19, 2012

Increasing Prevalence of Type 2 Diabetes in Chinese Adults in Shanghai RESULTS Age-standardized prevalence of diagnosed and undiagnosed type 2 diabetes increased from 5.1 and 4.6% in 2002–2003 to 7.4 and 5.2% in 2009. The prevalence of type 2 diabetes increased with age and was higher among men and in urban residents in both surveys (P < 0.001). Between the two surveys, the increase in the prevalence was more evident in the rural population (P < 0.001) and appeared more rapid in younger birth cohorts (P < 0.05). CONCLUSIONS Our results suggest that Shanghai has experienced an increasing burden of type 2 diabetes.   Rui Li, MD,   Wei Lu, MD, PHD,   Qing Wu Jiang, MD, MPH,   Yan Yun Li, MD,   Gen Ming Zhao, MD, PHD,   Liang Shi, MD,   Qun Di Yang, MD, MPH,   Ye Ruan, MD, PHD,   Junyi Jiang, MD,   Sheng Nian Zhang, MD,   Wang Hong Xu, MD, PHD and   Wei Jian Zhong, MD, PHD

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