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

Yongze Li, Di Teng, Xiaoguang Shi, Guijun Qin, Yingfen Qin, Huibiao Quan, Bingyin Shi, Hui Sun, Jianming Ba, Bing Chen, Jianling Du, Lanjie He, Xiaoyang Lai, Yanbo Li, Haiyi Chi, Eryuan Liao, Chao Liu, Libin Liu, Xulei Tang, Nanwei Tong, Guixia Wang, Jin-An Zhang, Youmin Wang, Yuanming Xue, Li Yan, Jing Yang, Lihui Yang, Yongli Yao, Zhen Ye, Qiao Zhang, Lihui Zhang, Jun Zhu, Mei Zhu, Guang Ning, Yiming Mu, Jiajun Zhao, Weiping Teng, Zhongyan Shan, Yongze Li, Di Teng, Xiaoguang Shi, Guijun Qin, Yingfen Qin, Huibiao Quan, Bingyin Shi, Hui Sun, Jianming Ba, Bing Chen, Jianling Du, Lanjie He, Xiaoyang Lai, Yanbo Li, Haiyi Chi, Eryuan Liao, Chao Liu, Libin Liu, Xulei Tang, Nanwei Tong, Guixia Wang, Jin-An Zhang, Youmin Wang, Yuanming Xue, Li Yan, Jing Yang, Lihui Yang, Yongli Yao, Zhen Ye, Qiao Zhang, Lihui Zhang, Jun Zhu, Mei Zhu, Guang Ning, Yiming Mu, Jiajun Zhao, Weiping Teng, Zhongyan Shan

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 (HbA1c).

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.

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: funding for the project through a grant (15010010589) from the Chinese Medical Association; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

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Fig 1
Prevalence, awareness, treatment, and control of diabetes diagnosed by the American Diabetes Association criteria among study participants

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