Editorial

Current situation and challenges of prevention and control of diabetes in China

  • NING Guang
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  • National Clinical Research Center for Metabolic Diseases; Shanghai Institute of Endocrine and Metabolic Diseases; Department of Endocrinology and Metabolic Diseases, Ruijin Hospita, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2024-11-08

  Accepted date: 2025-01-24

  Online published: 2025-02-25

Abstract

Diabetes has become a major global public health issue. As of 2021, China had approximately 141 million diabetic patients, with 2/3 remaining undiagnosed, making China the country with the highest number of diabetes globally. This current status poses severe challenges to the prevention and control of diabetes and its complications. To effectively address these challenges, strategies must be comprehensive and involve multi-sectoral collaboration, including nationwide primary prevention, primary prevention for high-risk groups, and secondary prevention for diabetic patients. For the general population, it is critical to promote healthy lifestyles through health education, policy guidance, and technical resource support. For high-risk groups, emphasis should be placed on the importance of diabetes screening, coupled with combined measures of lifestyle interventions and pharmacological treatments. For diabetic patients, the focus should be on the monitoring and management of pan-risk factors associated with cardiovascular complications. China has introduced a new model for diabetes management—the National Metabolic Management Center (MMC). By providing structured training and education for physicians within its network, the MMC promotes standardized, one-stop management solutions for diabetes, reducing regional disparities in diabetes management and effectively improving the diagnosis and treatment efficiency of diabetes and its complications. To achieve the goals of the "Healthy China 2030" initiative, concerted efforts from governments, sectors, communities, and individuals are required to raise diabetes awareness, expand standardized management coverage, and improve treatment and control rates, while reducing the incidence of diabetes and its complications. These efforts will lay a solid foundation for improving public health and building a healthy China for all.

Cite this article

NING Guang . Current situation and challenges of prevention and control of diabetes in China[J]. Journal of Diagnostics Concepts & Practice, 2025 , 24(01) : 1 -6 . DOI: 10.16150/j.1671-2870.2025.01.001

References

[1] XU Y, WANG L, HE J,et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA, 2013, 310(9):948-959.
[2] 健康中国行动推进委员会. 健康中国行动(2019-2030)[EB/OL]. 2019. https://www.gov.cnxinwen2019-0715content_5409694.htm.
  Healthy China Initiative Promotion Committee. Healthy China Initiative (2019–2030)[EB/OL]. 2019. https://www.gov.cnxinwen2019-0715content_5409694.htm.
[3] LIU J, LIU M, CHAI Z,et al. Projected rapid growth in diabetes disease burden and economic burden in China: a spatio-temporal study from 2020 to 2030[J]. Lancet Reg Health West Pac, 2023, 33:100700.
[4] SUN H, SAEEDI P, KARURANGA S,et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045[J]. Diabetes Res Clin Pract, 2022, 183:109119.
[5] PENG W, CHEN S, CHEN X,et al. Trends in major non-communicable diseases and related risk factors in China 2002-2019: an analysis of nationally representative survey data[J]. Lancet Reg Health West Pac, 2023, 43:100809.
[6] ZHAO Z, LI M, LI C,et al. Dietary preferences and diabetic risk in China: A large-scale nationwide Internet data-based study[J]. J Diabetes, 2020, 12(4):270-278.
[7] WU W, ZHANG J W, LI Y,et al. Population-based prevalence of self-reported pediatric diabetes and screening for undiagnosed type 2 diabetes in Chinese children in years 2017-2019, a cross-sectional study[J]. Lancet Reg Health West Pac, 2024, 52:101206.
[8] YUAN C, DONG Y, CHEN H,et al. Determinants of childhood obesity in China[J]. Lancet Public Health, 2024, 9(12):e1105-e1114.
[9] XIE J, WANG M, LONG Z,et al. Global burden of type 2 diabetes in adolescents and young adults, 1990-2019: systematic analysis of the Global Burden of Disease Study 2019[J]. BMJ, 2022, 379:e072385.
[10] YEUNG R O, ZHANG Y, LUK A,et al. Metabolic profiles and treatment gaps in young-onset type 2 diabetes in Asia (the JADE programme): a cross-sectional study of a prospective cohort[J]. Lancet Diabetes Endocrinol, 2014, 2(12):935-943.
[11] KE C, LAU E, SHAH B R,et al. Excess Burden of Mental Illness and Hospitalization in Young-Onset Type 2 Diabetes: A Population-Based Cohort Study[J]. Ann Intern Med, 2019, 170(3):145-154.
[12] BRAGG F, HOLMES M V, IONA A,et al. Association between diabetes and cause-specific mortality in rural and urban areas of China[J]. JAMA, 2017, 317(3):280-289.
[13] LU J, XU Y, BI Y,et al. Reducing inequity through tackling social determinants of cardiovascular diseases in China[J]. BMJ, 2024, 387:e079197.
[14] LI H, KHOR C C, FAN J,et al. Genetic risk, adherence to a healthy lifestyle, and type 2 diabetes risk among 550,000 Chinese adults: results from 2 independent Asian cohorts[J]. Am J Clin Nutr, 2020, 111(3):698-707.
[15] LI M, XU Y, WAN Q,et al. Individual and combined associations of modifiable lifestyle and metabolic health status with new-onset diabetes and major cardiovascular events: the china cardiometabolic disease and cancer cohort (4c) study[J]. Diabetes Care, 2020, 43(8):1929-1936.
[16] WANG Y, FENG L, ZENG G,et al. Effects of cuisine-based chinese Heart-Healthy Diet in lowering blood pressure among adults in china: multicenter, single-blind, randomized, parallel controlled feeding trial[J]. Circulation, 2022, 146(4):303-315.
[17] WANG J, LIN X, BLOOMGARDEN Z T,et al. The Jiangnan diet, a healthy diet pattern for Chinese[J]. J Diabetes, 2020, 12(5):365-371.
[18] 中国营养学会. 中国居民膳食指南(2022)[R/OL]. 2022. http://dg.cnsoc.org/index.html.
  Chinese Nutrition Society. Dietary guidelines for Chinese residents(2022)[R/OL]. 2022.http://dg.cnsoc.org/index.html.
[19] LI N, YE Q, DENG Q,et al. Physical activity intervention for leisure-time activity levels among older adults: A cluster randomized trial[J]. JAMA Netw Open, 2023, 6(9):e2333195.
[20] WANG H, BLAKE H, CHATTOPADHYAY K. School-based behaviour change intervention to increase physical activity levels among children: a feasibility cluster non-randomised controlled trial in Yangzhou, China[J]. BMJ Open, 2021, 11(10):e052659.
[21] CHAN K H, XIAO D, ZHOU M,et al. Tobacco control in China[J]. Lancet Public Health, 2023, 8(12):e1006-e1015.
[22] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)[J]. 中华内分泌代谢杂志, 2021, 37(4):311-398.
  Chinese Diabetes Society. Guideline for the prevention and treatment of type 2 diabetes mellitus in China (2020 edition) [J]. Chin J Endocrinol Metab, 2021, 37(4):311-398.
[23] LU J, HE J, LI M,et al. Predictive value of fasting glucose, postload glucose, and hemoglobin A1c on risk of diabetes and complications in Chinese adults[J]. Diabetes Care, 2019, 42(8):1539-1548.
[24] WU J, HOU X, CHEN L,et al. Development and validation of a non-invasive assessment tool for screening prevalent undiagnosed diabetes in middle-aged and elderly Chinese[J]. Prev Med, 2019, 119:145-152.
[25] ZHOU X, QIAO Q, JI L,et al. Nonlaboratory-based risk assessment algorithm for undiagnosed type 2 diabetes developed on a nation-wide diabetes survey[J]. Diabetes Care, 2013, 36(12):3944-3952.
[26] PAN X R, LI G W, HU Y H,et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study[J]. Diabetes Care, 1997, 20(4):537-544.
[27] GONG Q, ZHANG P, WANG J,et al. Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study[J]. Lancet Diabetes Endocrinol, 2019, 7(6):452-461.
[28] HOLMAN R R, COLEMAN R L, CHAN J C N,et al. Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trial[J]. Lancet Diabetes Endocrinol, 2017, 5(11):877-886.
[29] ZHANG L, ZHANG Y, SHEN S,et al. Safety and effectiveness of metformin plus lifestyle intervention compared with lifestyle intervention alone in preventing progression to diabetes in a Chinese population with impaired glucose regulation: a multicentre, open-label, randomised controlled trial[J]. Lancet Diabetes Endocrinol, 2023, 11(8):567-577.
[30] ZHENG R, XU Y, LI M,et al. Pan-risk factor for a comprehensive cardiovascular health management[J]. J Diabetes, 2022, 14(3):179-191.
[31] WANG T, LU J, SU Q,et al. Ideal cardiovascular health metrics and major cardiovascular events in patients with prediabetes and diabetes[J]. JAMA Cardiol, 2019, 4(9):874-883.
[32] BI Y, LI M, LIU Y,et al. Intensive blood-pressure control in patients with type 2 diabetes[J]. N Engl J Med, 2025, 392(12):1155-1167.
[33] 代谢中心学术委员会, 代谢中心专家顾问委员会, 代谢中心理事会, 等. 国家标准化代谢性疾病管理中心(MMC)代谢病管理指南(第二版)[J]. 中华内分泌代谢杂志, 2023, 39(6):538-554.
  Academic Committee of Metabolic Management Center, Expert Advisory Committee of Metabolic Management Center, Council of Metabolic Management Center,et al. Metabolic disease management guideline for National Metabolic Management Center(2nd edition)[J]. Chin J Endocrinol Metab, 2023, 39(6):538-554.
[34] RAZ I. MMC celebrating 6?years of experience and expansion[J]. J Diabetes, 2022, 14(5):356-357.
[35] 国家卫生健康委. 健康中国行动——糖尿病防治行动实施方案(2024—2030年)[EB/OL]. 2024. https://www.gov.cn/zhengce/zhengceku/202407/content_6965000.htm.
  National Health Commission. Healthy China Initiative:Implementation plan of diabetes prevention and control action(2024-2030)[EB/OL]. 2024.https://www.gov.cn/zhengce/zhengceku/202407/content_6965000.htm.
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