These days we’ve been used to China being the land of “the first,” “the largest” and “the highest.”  However, not all of these superlatives are worthy of praise.  China now has the largest diabetic population in the world (114 million), according to a recent study published by the Journal of the American Medical Association (JAMA).

Even more shocking is that China’s diabetes prevalence has increased from 1 percent in 1980 to 11.6 percent in 2010, which is even higher than the United States (11.3 percent). And the worst is yet to come. Indeed, 493 million people, or one in two adults, in China are thought to have prediabetes, or abnormally high blood sugar levels that presage the disease. According to Dr. Ji Linong, a leading Chinese expert on diabetics, each year, six to seven percent of those with prediabetes—amounting to approximately 30 million—will be added to the diabetes population estimate. If this true, China’s diabetes population already exceeds 130 million. (A 2010 article in the New England Journal of Medicine forecasted China would reach this benchmark by 2030.)

The high diabetes prevalence in China reflects a combination of genetic and environmental influences

The high diabetes prevalence in China reflects a combination of genetic and environmental influences

Other things being equal, Asians are more likely than Caucasians to develop diabetes even at a body weight considered “normal” by mainstream western standards.  Also, more than half of the Chinese live in cities (as opposed to 20 percent in 1980); 9 percent of the population are aged over 65 (as opposed to 5 percent in 1982). In addition, Chinese are leading increasingly sedentary lives while turning to increased high-calorie, high-fat, and high-sodium diets. According to a nationwide Disease Surveillance Points (DSPs) survey carried out by China CDC, the per capita sodium intake is 10.6 g/day (compared to <2g/day recommended by the WHO), and among the population aged over 18, only 12 percent exercise on a regularly basis, 32 percent are overweight, and 12 percent are obese.

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China’s Diabetes Epidemic