International Journal of Public Health

, Volume 61, Issue 3, pp 347–356 | Cite as

Prevalence, diagnosis, and management of diabetes mellitus among older Chinese: results from the China Health and Retirement Longitudinal Study

  • Yaohui Zhao
  • Eileen M. Crimmins
  • Peifeng Hu
  • Yang Shen
  • James P. Smith
  • John Strauss
  • Yafeng Wang
  • Yuan Zhang
Original Article



To estimate prevalence of diabetes mellitus (DM), success in diagnosing, and methods of diabetes management in China.


China Health and Retirement Longitudinal Study, a representative survey of the Chinese population at least 45 years old, is used to estimate diabetes and prediabetes prevalence, diagnosis, and treatment and their associations with residence, socioe-conomic, and demographic factors.


Almost 60 % of middle-aged and elderly Chinese have prediabetes or diabetes in 2011–2012. DM prevalence increases with age, but the oldest group is least likely to be diagnosed. Prevalence is higher with higher body mass index, fasting cholesterol, and larger waist circumference. Higher prevalence is found in urban areas among residents with urban registration status (the Chinese administrative registration system or hukou), especially in coastal regions. Better rates of diagnosis, management, and education regarding diabetes are strongly associated with urban hukou, living in coastal areas, and in families with higher per capita expenditures, the appropriate economic resources measure in China.


Diagnosis and management of diabetes is highly differential within China but recent efforts to improve health systems are succeeding in reducing undiagnosed disease. Current high prevalence of prediabetes suggests a more intensive effort is required in the future.


Diabetes mellitus China Management SES Undiagnosis 


Compliance with ethical standards


This research was supported by the BSR division of the National Institute on Aging (1R01AG037031-03S, R03AG049144 and R37AG025529), the Management Science Division of the National Natural Science Foundation of China (71130002 and 71450001), Development Research Group-Human Development and Public Services Team of the World Bank (7172961), China Medical Board and Peking University.


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Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  • Yaohui Zhao
    • 1
  • Eileen M. Crimmins
    • 2
  • Peifeng Hu
    • 3
  • Yang Shen
    • 4
  • James P. Smith
    • 5
  • John Strauss
    • 6
  • Yafeng Wang
    • 7
  • Yuan Zhang
    • 2
  1. 1.National School of DevelopmentPeking UniversityBeijingChina
  2. 2.Davis School of GerontologyUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.UCLA Division of Geriatric MedicineLos AngelesUSA
  4. 4.UCLA Division of Endocrinology, Diabetes and HypertensionLos AngelesUSA
  5. 5.RAND CorporationSanta MonicaUSA
  6. 6.Department of EconomicsUniversity of Southern CaliforniaLos AngelesUSA
  7. 7.Institute for Social Science SurveyPeking UniversityBeijingChina

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