Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study

Yongze Li(Harbin Medical University), Di Teng(First Hospital of China Medical University), Xiaoguang Shi(First Hospital of China Medical University), Guijun Qin(First Affiliated Hospital of Zhengzhou University), Yingfen Qin(Guangxi Medical University), Huibiao Quan(Hainan General Hospital), Bingyin Shi(First Affiliated Hospital of Xi'an Jiaotong University), Hui Sun(Union Hospital), Jianming Ba(Chinese PLA General Hospital), Bing Chen(Army Medical University), Jianling Du(Dalian Medical University), Lanjie He(Ningxia Medical University), Xiaoyang Lai(Nanchang University), Yanbo Li(Harbin Medical University), Haiyi Chi(Hohhot First Hospital), Eryuan Liao(Central South University), Chao Liu(Nanjing University of Chinese Medicine), Libin Liu(Fujian Medical University), Xulei Tang(First Hospital of Lanzhou University), Nanwei Tong(Sichuan University), Guixia Wang(Jilin University), Jin‐an Zhang(Shanghai University of Medicine and Health Sciences), Youmin Wang(Anhui Medical University), Yuanming Xue(First People's Hospital of Yunnan Province), Li Yan(Sun Yat-sen University), Jing Yang(Shanxi Medical University), Lihui Yang(Tibet Autonomous Region People's Hospital), Yongli Yao(Qinghai Provincial Peoples Hospital), Zhen Ye(Zhejiang Center for Disease Control and Prevention), Qiao Zhang(Guiyang Medical University), Lihui Zhang(Hebei Medical University), Jun Zhu(Xinjiang Medical University), Mei Zhu(Tianjin Medical University General Hospital), Guang Ning(Shanghai Jiao Tong University), Yiming Mu(Chinese PLA General Hospital), Jiajun Zhao(Shandong University), Weiping Teng(First Hospital of China Medical University), Zhongyan Shan(First Hospital of China Medical University)
BMJ
April 28, 2020
10.1136/bmj.m997
Cited by 1,611Open Access
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Abstract

Abstract Objective To assess the prevalence of diabetes and its risk factors. Design Population based, cross sectional study. Setting 31 provinces in mainland China with nationally representative cross sectional data from 2015 to 2017. Participants 75 880 participants aged 18 and older—a nationally representative sample of the mainland Chinese population. Main outcome measures Prevalence of diabetes among adults living in China, and the prevalence by sex, regions, and ethnic groups, estimated by the 2018 American Diabetes Association (ADA) and the World Health Organization diagnostic criteria. Demographic characteristics, lifestyle, and history of disease were recorded by participants on a questionnaire. Anthropometric and clinical assessments were made of serum concentrations of fasting plasma glucose (one measurement), two hour plasma glucose, and glycated haemoglobin (HbA 1c ). Results The weighted prevalence of total diabetes (n=9772), self-reported diabetes (n=4464), newly diagnosed diabetes (n=5308), and prediabetes (n=27 230) diagnosed by the ADA criteria were 12.8% (95% confidence interval 12.0% to 13.6%), 6.0% (5.4% to 6.7%), 6.8% (6.1% to 7.4%), and 35.2% (33.5% to 37.0%), respectively, among adults living in China. The weighted prevalence of total diabetes was higher among adults aged 50 and older and among men. The prevalence of total diabetes in 31 provinces ranged from 6.2% in Guizhou to 19.9% in Inner Mongolia. Han ethnicity had the highest prevalence of diabetes (12.8%) and Hui ethnicity had the lowest (6.3%) among five investigated ethnicities. The weighted prevalence of total diabetes (n=8385) using the WHO criteria was 11.2% (95% confidence interval 10.5% to 11.9%). Conclusion The prevalence of diabetes has increased slightly from 2007 to 2017 among adults living in China. The findings indicate that diabetes is an important public health problem in China.

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