Nearly half of Chinese adults have diabetes or prediabetes
medwireNews: The latest survey of diabetes in China reports that 47% of the adult population had either diabetes or prediabetes in 2013.
Writing in JAMA, the researchers Linhong Wang (Chinese Center for Disease Control and Prevention, Beijing) and colleagues say that these figures indicate China “now has the world’s largest diabetes epidemic.”
The survey, which was conducted with a nationally representative population of more than 170,000 participants, estimated that 10.9% of Chinese adults had diabetes and 35.7% – 388.1 million Chinese adults – had prediabetes.
The prevalence of diabetes was significantly higher among men, those older than 40 years, those living in urban or economically developed areas, and overweight and obese participants (even when Asian-specific body mass index [BMI] cutoffs were used).
The prevalence of diabetes was similar to that reported for the USA in 2011–2012, despite the average BMI of the participants being much lower. But analyses by BMI found that overweight Chinese participants had a far higher prevalence of diabetes than overweight US participants. The authors therefore surmise that “Asians may have a higher risk of developing diabetes at a given BMI,” although the difference was reduced when Asian-specific BMI cutoffs were applied.
China has 56 ethnic groups, with Chinese Han forming the majority. The large sample size of this study provided, to the researchers’ knowledge, “the first direct comparison of diabetes prevalence among major minority groups in China within 1 survey” and allowed the identification of several interesting variations with respect to the prevalence of diabetes among the major minorities in China.
Of the ethnic groups analyzed in this study (those with ≥1000 participants), Tibetan and Muslim Chinese adults had a significantly lower crude prevalence of diabetes, at 4.3% and 10.6%, respectively, than Han participants, at 14.7%. The highest prevalence, at 15.0%, was found among the Manchu population. Similar results were found for prediabetes. Further studies are required to investigate the causes of these differences, says the team.
Although higher diabetes and prediabetes prevalences of 11.6% and 50.1%, respectively, were reported in a previous 2010 survey of China, that survey calculated glycated hemoglobin (HbA1c) levels by converting capillary HbA1c. By contrast, the 2013 survey directly measured HbA1c from venous blood samples stored at –80°C, which, say the authors, is a more reliable method and “the most likely reason for the discrepancy in prediabetes prevalence” between the two surveys.
By Catherine Booth
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