Abstract
China’s diabetes epidemic is getting worse. People with diabetes in China usually have a lower body weight and a different lifestyle profile compared to their counterparts in the United States (US). More and more evidence show that certain lifestyles can possibly be spread from person to person, leading some to propose considering social influence when establishing preventive policies. This study developed an innovative agent-based model of the diabetes epidemic for the Chinese population. Based on the risk factors and related complications of diabetes, the model captured individual health progression, quantitatively described the peer influence of certain lifestyles, and projected population health outcomes over a specific time period. We simulated several hypothetical interventions (i.e., improving diet, controlling smoking, improving physical activity) and assessed their impact on diabetes rates. We validated the model by comparing simulation results with external datasets. Our results showed that improving physical activity could result in the most significant decrease in diabetes prevalence compared to improving diet and controlling smoking. Our model can be used to inform policymakers on how the diabetes epidemic develops and help them compare different diabetes prevention programs in practice.
Highlights
There are 415 million people with diabetes in the world
We developed an agent-based model of diabetes based on the risk factors and related complications of diabetes to inform decision makers on how the diabetes epidemic develops in China
The nationally representative data of China were extracted from the following datasets: The Chinese National Sample Survey, the WHO Global Health Observatory; the China Health and Nutrition Survey (CHNS) and data from Non-Communicable Diseases Risk
Summary
There are 415 million people with diabetes in the world. A total of 642 million people is expected to develop diabetes by 2040 [1]. As a prevalent non-communicable metabolic disease, diabetes can lead to many serious complications such as blindness and lower-extremity amputation [2,3]. Global aging and the growing trend of obesity and unhealthy lifestyles are major contributors to the diabetes epidemic [4,5,6]. Previous studies have shown that lifestyle modifications may be a more effective in preventing and controlling diabetes compared to medical interventions for people with pre- and early-stage diabetes [7,8]. The trials implemented in China showed that diet and exercise brought a significant reduction in the diabetes rate of the trial population over a six-year period [9]
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