China becomes world's new diabetes capital

NEW YORK (Reuters Health) - China now has more people with diabetes than any other country, a new report shows, making it clear that the nation’s soaring economic growth is taking a toll on public health.

A Type 1 diabetic fills her needle with insulin in downtown Los Angeles July 30, 2007. REUTERS/Lucy Nicholson

According to the report, more than 92 million adults in China have diabetes, and nearly 150 million more are well on their way to developing it. The disease is more common in people with large waistlines and in those who live in cities, the report indicates.

“For every person in the world with HIV there are three people in China with diabetes,” said David Whiting, an epidemiologist with the International Diabetes Federation, who was not involved in the research.

The Federation projected last year that some 435 million people would have diabetes by 2030. “With this new study, we’re going to have to rerun our estimate,” Whiting told Reuters Health.

The report, published Thursday in the New England Journal of Medicine, is based on a nationally representative sample of more than 46,000 people who were tested for diabetes.

For each person, doctors measured blood sugar levels up to two hours after subjects had swallowed a sugar solution or, in cases where diabetes was suspected, eaten a bun. Because people with diabetes can’t use the sugar in their blood effectively, a high blood sugar level indicates disease.

Based on their findings, the researchers calculate that about 50 million men and 42 million women have diabetes, or almost 1 in 10 adults. And in most cases, the disease is undiagnosed.

The prevalence is twice as high as estimates suggested by previous studies, which did not use World Health Organization-recommended tests to diagnose diabetes, and is similar to US numbers. It would place China far ahead of India, whose estimated 50 million diabetics lands it a dubious second place in terms of the total number of people with diabetes.

“These data really show diabetes has become a major epidemic in China,” Dr. Jiang He, of Tulane University in New Orleans, told Reuters Health.

He, who worked on the new study with colleagues in China, noted that diabetes is a risk factor for heart disease, which is now the biggest killer in the country.

“We basically need to make diabetes one of the top priorities for public health in China,” he said.

Dr. Vivian Fonseca, a diabetes expert at Tulane who was not involved in the study, said rates of the disease have soared in many countries around the world -- including China and India -- mainly because of the larger calorie intake and reduction in physical activity that come with better economies.

“There is really nothing surprising in this,” Fonseca said. “Exactly what has happened in the US over the last 20 years is going to happen much faster in these countries.”

According to the new report, more than one in seven people were “pre-diabetic,” meaning they had increases in blood sugar levels that often lead to full-blown disease.

But moderate changes in lifestyle, such as walking 30 minutes every day or eating a little less, could go a long way in changing this grim picture, experts say.

“The challenge now,” Fonseca said, “is to make sure that everybody increases physical activity and cuts back on calories.”

SOURCE: The New England Journal of Medicine, March 25, 2010.