More than 400 million people worldwide are being impacted by the diabetes pandemic (Hu & Jia, 2018). The majority of diabetics live in the Asia Pacific area, where the incidence of the disease has increased significantly over the past several decades. With a populace of about 1.40 billion and approximately 110 million individuals suffering from diabetes, China has the highest diabetes prevalence worldwide at the moment (Hu & Jia, 2018). Given the stage of the pandemic, it is anticipated that the prevalence of diabetes will continue to climb, placing a heavy strain on the medical system. One of the most notable instances is the difficulty that diabetes presents for China, which will be discussed through an epidemiologic perspective over the years.
Diabetes occurrences in China have grown from 55,167,473 in 2000 to 89,783,100 in 2016, which indicates a 62.7 percent increase (Hu & Jia, 2018). As a result, 90 million Chinese people had this disease in 2016. Age-standardized prevalence rates climbed until 2005 when they started to decline. Between 1990 and 2016, all-age incidence rates grew by 78.4 percent, from 3.7 percent to 6.6 percent (Hu & Jia, 2018). Nevertheless, it increased from 4.6 percent to 5.4 percent between 1990 and 2016, a 17.4 percent increase. Its current incidence rate roughly resembles the Global Burden of Disease 2016 estimate of 5.5 percent (Hu & Jia, 2018). In 2016, China saw a record 140,838 diabetes-related fatalities. From 6.3 in 1990 to 10.3 in 2016, the diabetes fatality rates per 100,000 people increased by 63.5 percent (Hu & Jia, 2018).
Disability-adjusted life years (DALYs) demonstrated an increase from 4,274,697.2 in 1990 to 8,337,262.8 in 2016, a 95 percent shift. Contrarily, age-standardized rates of diabetes-associated DALYs increased just by 2.3 percent, from 502.0 to 513.7 per 100,000, indicating that population explosion and aging were likely the primary factors for the observed rise in the overall quantity of DALYs linked to the disease (Liu et al., 2018). In 2013, rates in the North and Southwest parts of the country were reportedly lower than those in the South, Northwest, and Northeast of the PRC, according to the related indicators of DALYs per 100,000 in 1990 and 2016 (Liu et al., 2018). Age-standardized DALYs rates declined the greatest in the South, Southwest, and Northeast between 1990 and 2016.
China is the most populated country on the planet and has the highest incidence of diabetes worldwide (6.6%) – it demonstrates the highest quantity of diabetics. Diabetes in the country has shown fast growth in recent years in comparison with Western nations, with fairly premature onset of the disease and poor rates of disease knowledge and treatment. Therefore, diabetes prevention programs and healthcare awareness must be introduced among the PRC working-age people. All-age death rates from diabetes increased in China between 1990 and 2016, despite the age-standardized fatality rates for all non-communicable diseases declining more quickly in China (37.4%) than they did globally (25.1%) (Hu & Jia, 2018).
From 1990 to 2016, the rate of age-standardized DALYs declined in fourteen provinces while rising in nineteen others. The varying concentrations of diabetes risk markers in each province contributed to the mentioned regional variations. To better understand the distinct differences in the burden of the disease, the amount of sensitivity to diabetes risk determinants should be evaluated at the regional level. The diverse DALYs per province also have significant public health consequences. Given limited health resources, focused, cost-effective intervention techniques and focused programming are needed.
The large increase in diabetes-related morbidity reflects a continuous concern, given the increasingly aging Chinese society. To lessen this load, a focused regulatory and preventative approach must be designed at the risk factor levels.
Causes of Changes
The Chinese population has rapidly advanced over the past thirty years, with demographic shifts and lifestyle modifications having a significant influence on public health. The prevalence of non-communicable diseases like diabetes, which are caused by personal behaviors and practices, is continuously rising even if the prevalence of infectious diseases has dropped significantly.
In China, BMI has risen to the top of the list of diabetes risk factors. Even though grains constitute a staple food in China, the proportion of carbs in total calorie consumption fell from 68.8% in 1991 to 60% in 2014 (Ma, 2018). Additionally, the bulk of grains eaten in China is processed, including white rice and processed wheat flour, which significantly increases the glycemic index of the diet.
Given the continued low consumption of nutritious foods, including fruits, nuts, and seeds, dietary variables connected to diabetes are not optimistic. Additionally, smoking and inactivity are significant risk factors for developing diabetes in China.
Policies like Healthy China 2030 and long-standing strategies for the mitigation and therapy of chronic illnesses have been implemented to halt or even stop the increasing diabetes pandemic in China (Shen et al., 2016). Similarly, interventional initiatives such as China Healthy Lifestyle for All and National Demonstrative Districts for NCD Prevention and Control were also put in place, with general practice as another framework for delivering measures. Among them are the identification and medicinal strategic planning of HFPG and impaired fasting glucose and also diabetes monitoring and planning.
Over the last thirty years, China had a sharp rise in the prevalence of diabetes. Hence, to lessen the burden on the healthcare sector, programs, and strategies are now critically required to raise awareness of diabetes, lower its risk factors, and enhance the diagnosis of diabetes and treatment. The medical, educational, and social sectors, as well as the food industries and the media, are just a few of the participating areas that must be involved in each of these tasks.
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Liu, M., Liu, S., Wang, L., Bai, Y., Zeng, X., Guo, H., … Shicheng, Y. (2018). Burden of diabetes, hyperglycaemia in China from to 2016: findings from the 1990 2016, Global Burden of Disease study. Diabetes & Metabolism.
Ma, R. C. (2018). Epidemiology of diabetes and diabetic complications in China. Diabetologia, 61(6), 1249-1260.
Shen, X., Vaidya, A., Wu, S., & Gao, X. (2016). The diabetes epidemic in China: an integrated review of national surveys. Endocrine Practice, 22(9), 1119-1129.