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Original Investigation
September 4, 2013

Prevalence and Control of Diabetes in Chinese Adults

Author Affiliations
  • 1Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, State Key Laboratory of Medical Genomics, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
  • 2National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
  • 3Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
  • 4Department of Endocrinology, Fuwai Hospital, Beijing, China
  • 5Department of Endocrinology, Chinese People’s Liberation Army General Hospital, Beijing, China
  • 6Department of Endocrinology, Shandong Provincial Hospital, Shandong, China
  • 7Department of Disease Control, Ministry of Health, Beijing, China
  • 8Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
JAMA. 2013;310(9):948-959. doi:10.1001/jama.2013.168118
Abstract

Importance  Noncommunicable chronic diseases have become the leading causes of mortality and disease burden worldwide.

Objective  To investigate the prevalence of diabetes and glycemic control in the Chinese adult population.

Design, Setting, and Participants  Using a complex, multistage, probability sampling design, we conducted a cross-sectional survey in a nationally representative sample of 98 658 Chinese adults in 2010.

Main Outcomes and Measures  Plasma glucose and hemoglobin A1c levels were measured after at least a 10-hour overnight fast among all study participants, and a 2-hour oral glucose tolerance test was conducted among participants without a self-reported history of diagnosed diabetes. Diabetes and prediabetes were defined according to the 2010 American Diabetes Association criteria; whereas, a hemoglobin A1c level of <7.0% was considered adequate glycemic control.

Results  The overall prevalence of diabetes was estimated to be 11.6% (95% CI, 11.3%-11.8%) in the Chinese adult population. The prevalence among men was 12.1% (95% CI, 11.7%-12.5%) and among women was 11.0% (95% CI, 10.7%-11.4%). The prevalence of previously diagnosed diabetes was estimated to be 3.5% (95% CI, 3.4%-3.6%) in the Chinese population: 3.6% (95% CI, 3.4%-3.8%) in men and 3.4% (95% CI, 3.2%-3.5%) in women. The prevalence of undiagnosed diabetes was 8.1% (95% CI, 7.9%-8.3%) in the Chinese population: 8.5% (95% CI, 8.2%-8.8%) in men and 7.7% (95% CI, 7.4%-8.0%) in women. In addition, the prevalence of prediabetes was estimated to be 50.1% (95% CI, 49.7%-50.6%) in Chinese adults: 52.1% (95% CI, 51.5%-52.7%) in men and 48.1% (95% CI, 47.6%-48.7%) in women. The prevalence of diabetes was higher in older age groups, in urban residents, and in persons living in economically developed regions. Among patients with diabetes, only 25.8% (95% CI, 24.9%-26.8%) received treatment for diabetes, and only 39.7% (95% CI, 37.6%-41.8%) of those treated had adequate glycemic control.

Conclusions and Relevance  The estimated prevalence of diabetes among a representative sample of Chinese adults was 11.6% and the prevalence of prediabetes was 50.1%. Projections based on sample weighting suggest this may represent up to 113.9 million Chinese adults with diabetes and 493.4 million with prediabetes. These findings indicate the importance of diabetes as a public health problem in China.

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