The Chinese are beginning to learn the downside of prosperity. After conducting a survey of a sample population, the 2010 China Noncommunicable Disease Surveillance Group estimates the prevalence of diabetes among adults to be 11.6 percent. With rates higher among urban residents, those living in economically developed regions, and the elderly, the overall rate quoted by the Surveillance Group even surpasses numbers recorded in the U.S.

“These findings indicate the importance of diabetes as a public health problem in China,” wrote the authors of the study.

Sample Numbers

To arrive at their estimates, the researchers conducted a cross-sectional survey in a nationally representative sample of 98,658 Chinese adults in the year 2010. Relying on American Diabetes Association criteria, they measured levels of plasma glucose, among other tests, in participants. Diabetes is a group of diseases that affect how the body uses blood glucose, commonly called blood sugar, and it is marked by high levels of blood glucose. Glucose is a source of energy for muscle and tissue cells, while also being the main source of fuel for the brain.

The prevalence of diabetes among adult men was calculated as 12.1 percent; among adult women, the prevalence was 11 percent, with an overall rate estimated at 11.6 percent for the adult population. This just happens to be a slender 0.3 percentage points higher than in America, where 25.6 million people over the age of 20 have the disease, according to the Centers for Disease Control and Prevention (CDC).

Previously, diagnosed diabetes was estimated to be 3.5 percent among Chinese adults, meaning about two out of every 25 people (or 8.1 percent) remain unaware of their status. Among those with full knowledge of their condition, little more than a quarter received treatment, while less than half of those treated (39.7 percent) had adequate glycemic control.

Worse, the prevalence of prediabetes was estimated to affect just over half (50.1 percent) of the adult population. In comparison, 35 percent of U.S. adults aged 20 years or older had prediabetes, according to the CDC as estimated during the years 2005 to 2008.

“Projections based on sample weighting suggest this may represent up to 113.9 million Chinese adults with diabetes and 493.4 million with prediabetes,” wrote the authors of the study, which was led by Guang Ning, head of the Shanghai Institute of Endocrine and Metabolic Diseases.

Prevention

Type 1 diabetes — where the immune system attacks and destroys insulin-producing cells in the pancreas — is thought to be caused by a combination of genetic susceptibility and environmental factors. It is not preventable. Type 2 diabetes, on the other hand, can be prevented; weight, inactivity, and family history are the primary risk factors for type 2 diabetes.

In type 2 diabetes and prediabetes, the body’s cells become resistant to the action of insulin, while the pancreas is unable to make enough insulin to overcome this resistance. Symptoms may include increased thirst, frequent urination, fatigue, high blood pressure, extreme hunger, and blurred vision, among others. Long-term complications, such as cardiovascular disease and nerve damage, may develop gradually, but they can lead to disability and even death.

Prediabetes — when blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes (which may occur during pregnancy) are both considered reversible conditions. Gestational diabetes often resolves on its own after the baby is delivered, while prediabetes may be overturned through lifestyle interventions.

Lifestyle intervention to lose weight and increase physical activity reduced the development of type 2 diabetes by 58 percent during a three-year period, the CDC found. The reduction was even greater — 71 percent — among adults aged 60 years or older. Doctors generally recommend a third step to delay or prevent onset of the disease: eat only healthy foods.

Sources: Xu Y, Wang L, He J, et al. Prevalence and Control of Diabetes in Chinese Adults. Journal of the American Medical Association. 2013.

U.S. Department of Health and Human Services. Centers for Disease Control and Prevention National Diabetes Fact Sheet. 2011.