Abstract 011: Prevalence and Control of Diabetes in Chinese Adults: The China Metabolic Risk Factor Study

Abstract

Objective: Diabetes is a major risk factor for vascular disease in the general population. We investigated the prevalence of diabetes and glycemic control in the Chinese adult population. Methods: We conducted a cross-sectional survey in a nationally representative sample of 98,658 Chinese adults aged ≥18 years in 2010. After an overnight fast, participants without known diabetes underwent an oral glucose-tolerance test (OGTT) using 75 g anhydrous glucose dissolved in water. Previously diagnosed diabetes was determined on the basis of self-report. Undiagnosed diabetes was defined as a hemoglobin A1c (A1c) ≥ 6.5% or fasting plasma glucose (FPG) ≥126 mg/dl (7.0 mmol/l) or 2-h plasma glucose (2-h PG) ≥200 mg/dl (11.1 mmol/l) during an OGTT according to the 2010 American Diabetes Association criteria. Pre-diabetes was defined as FPG 100-125 mg/dl (5.6-6.9 mmol/l) or 2-h PG 140-199 mg/dl (7.8-11.0 mmol/l) or A1c 5.7-6.4%. Prevalence was calculated by weighting sampling factors derived from China population census data in 2010 to obtain national estimates. Results: Prevalence of self-reported diabetes was estimated to be 3.5% in the Chinese population aged ≥18 years (3.6% in men and 3.4% in women) or 34.2 million persons (18.0 million men and 16.3 million women). Prevalence of undiagnosed diabetes was 8.1% (8.5% in men and 7.7% in women) or 79.6 million persons (42.5 million men and 37.1 million women), and the prevalence of pre-diabetes was 50.1% (52.1% in men and 48.1% in women) or 493.4 million persons (260.1 million men and 233.3 million women). The prevalence of diabetes was higher in urban (14.3%) than in rural (10.3%) residents, and higher in persons who were older, heavier, and living in economically developed areas. The proportion of controlled (A1c <7.0%) was 42.8% among self-reported diabetes (42.3% in men and 43.4% in women) in the general population in China. Conclusions: Our study shows that the prevalence of diabetes in the general population in China is much higher than previously reported. More troublesome, 7 out of every 10 diabetic patients are undiagnosed. Among self-reported diabetes, 3 out of 5 were poorly controlled. Our findings indicate that diabetes has become a major public health problem in China and suggest an urgent need to develop national strategies for prevention and treatment of diabetes.