Rate of diabetes in China “explosive”
Healthy diet and exercise key to turning the tide
BEIJING, 6 April 2016 - Almost 10% of all adults in China – about 110 million people – currently live with diabetes. Without urgent action to reduce lifestyle risk factors like unhealthy diet and lack of physical activity, that number is expected to increase to 150 million by 2040 – with major health, social and economic consequences.
The theme of this year’s World Health Day is ‘Beat Diabetes’. This provides an opportunity to reflect on the causes of the increasing prevalence of the disease in China, as well as to discuss what can be done to stem the tide.
Type 1 diabetes (sometimes called juvenile diabetes) is characterized by deficient insulin production and requires daily administration of insulin. The cause of Type 1 diabetes is unknown. Type 2 diabetes results from the body’s ineffective use of insulin. Type 2 diabetes comprises 90% of people with diabetes around the world, and is largely the result of excess body weight and physical inactivity.
“Rates of Type 2 diabetes in China have exploded in the last couple of decades. In 1980, less than 5% of Chinese men had diabetes. Now, more than 10% do. This increase has been largely driven by unhealthy lifestyles – diets that are too high in sugar and fat, and people not getting enough physical activity,” said Dr Bernhard Schwartländer, WHO Representative in China.
Even more startling is the fact that almost half of all adults in China – close to 500 million people – have prediabetes. Not only does this pose a risk factor for developing Type 2 diabetes, but also for other conditions such as cardiovascular disease.
Unhealthy diets and lack of physical activity are driving increasing rates of overweight and obesity in China – which are themselves risk factors for developing Type 2 diabetes. More than one-third of adults in China are overweight, while 7% of adults are obese.
Unhealthy lifestyles are also putting China’s children at risk of developing diabetes: more than 4 in 5 adolescents 11-17 years do not get enough physical activity, and rates of overweight and obesity in children are increasing rapidly: from less than 3% in 1985 to around 1 in 10 in girls and 1 in 5 boys in 2010.1
Noncommunicable diseases (NCDs), including diabetes, are China's number one health threat, contributing more than 80% of the country's 10.3 million annual deaths, and nearly 70% of its total disease burden. Diabetes and complications from diabetes contribute to almost 1 million deaths in China each year. Alarmingly, nearly 40% of these deaths are premature (that is, in people below the age of 70).
“Making some simple lifestyle changes can go a long way towards reducing the risk getting of diabetes and other NCDs. Consuming less sugar, salt and fat, eating more fruits and vegetables, and getting more physical activity are key to helping reverse the tide,” said Dr Schwartländer.
Diabetes is unfortunately an incurable disease. But once diagnosed the disease can be managed – especially if detected early – and consequences like heart disease, kidney failure to blindness can be avoided. For the 110 million people in China already living with the disease, there is a need to strengthen early detection, diagnosis and treatment.
There is much work to be done in China in this regard: more than half (53%) of people with diabetes in China may be undiagnosed, and according to a survey in 2010 only one-quarter (25.8%) of all people with diabetes were receiving treatment for their condition.2
“Building stronger primary and community health care services – so that those who have diabetes get diagnosed, and those who are diagnosed get the treatment and care that they need – is absolutely essential to improving the lives of people with diabetes and helping them live long and healthy lives,” said Dr Schwartländer.
In addition to the physical and emotional toll diabetes can take on people with diabetes and their families and friends, there is also a significant economic cost: China spends upwards of RMB 173.4 billion (US $25 billion) a year on the management of diabetes, and 13% of China's medical expenditures are directly caused by diabetes.3 These numbers do not include the economic losses that families and companies suffer from due to diabetes linked illnesses.
“The rise of diabetes in China is to some extent a side effect of China’s rapid economic development. We know, for instance, that the disease’s prevalence is higher among urban residents and people living in economically developed regions. But without action to stem the tide of increasing rates of diabetes and other lifestyle-related NCDs, the cost of these diseases will overwhelm the health system in the future,” Dr Schwartländer said.
“Beating Diabetes is therefore much more than just a health issue, but rather a social and economic issue which requires a whole-of-society solution. Individually, all of us can do more to reduce our own risk – by eating healthily, and getting more exercise. Governments at all levels and the broader community also have a role to play – to make healthy choices easier for everyone,” Dr Schwartländer concluded.
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1. Hong Xue, Yang Wu, Xiaoyu Wang, Youfa Wang. “Time Trends in Fast Food Consumption and Its Association with Obesity among Children in China,” PLOS ONE, Published March 12 2016.
2. International Diabetes Federation, Diabetes Atlas – 7th Edition, 2015; Yu Xu et al. "Prevalence and Control of Diabetes in Chinese Adults," The Journal of the American Medical Association, 310.9 (2013): 948-959.
3. Tsung O. Cheng, "Diabetes Epidemic in China and Its Economic Impact," International Journal of Cardiology, 149.1 (2011): 1-3.