Skip to main content
Log in

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

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

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

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Diabetes Association (2015) Classification and diagnosis of Diabetes. Diabetes Care 38:S8–S16

    Article  Google Scholar 

  • Chan JC, Zhang Y, Ning G (2014) Diabetes in China: a societal solution for a personal challenge. Lancet Diabetes Endocrinol 2:969–979

    Article  PubMed  Google Scholar 

  • Chen Z (2009) Launch of the health-care reform plan in China. Lancet 373:1322–1324

    Article  PubMed  Google Scholar 

  • Deaton A (1997) The analysis of household surveys. Johns Hopkins University Press, Baltimore

    Book  Google Scholar 

  • Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Eng J Med 329:977–986

    Article  Google Scholar 

  • Elgart JF, Asteazarán S, De La Fuente JL, Camillucci C, Brown JB, Gagliardino JJ (2014) Direct and indirect costs associated to type 2 diabetes and its complications measured in a social security institution of Argentina. Int J Public Health 59:851–857

    Article  PubMed  Google Scholar 

  • Gaede P, Vedel P, Larsen N et al (2003) Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Eng J Med 348:383–393

    Article  Google Scholar 

  • GBD 2013 Mortality and Causes of Death Collaborators (2015) Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systemic analysis for the global burden of disease study. Lancet 385:117–171

    Article  PubMed Central  Google Scholar 

  • Hsu WC, Araneta MR, Kanaya AM, Chiang JL, Fujimoto W (2015) BMI cut points to identify at-risk Asian Americans for type 2 diabetes screening. Diabetes Care 38:150–158

    Article  PubMed  PubMed Central  Google Scholar 

  • Hu FB (2011) Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care 34:1249–1257

    Article  PubMed  PubMed Central  Google Scholar 

  • Hu D, Fu P, Xie J et al (2008) Increasing prevalence and low awareness, treatment and control of diabetes mellitus among Chinese adults: the InterASIA study. Diabetes Res Clin Pract 81:250–257

    Article  PubMed  Google Scholar 

  • International Diabetes Federation. https://www.idf.org/BRIDGES/map/china. Accessed 29 Mar 2015

  • Jia WP, Pang C, Chen L et al (2007) Epidemiological characteristics of diabetes mellitus and impaired glucose regulation in a Chinese adult population: the Shanghai Diabetes Studies, a cross-sectional 3 year follow-up study in Shanghai urban communities. Diabetologia 50:286–292

    Article  CAS  PubMed  Google Scholar 

  • Kong AP, Chan NN, Chan JC (2013) Diabetes and its comorbidities—where East meets West. Nat Rev Endocrinol 9:537–547

    Article  CAS  PubMed  Google Scholar 

  • Levesque J-F, Mukherjee S, Grimard D, Boivin A, Mishra S (2013) Measuring the prevalence of chronic diseases using population surveys by pooling self-reported symptoms, diagnosis and treatments: results from the World Health Survey of 2003 for South Asia. Int J Public Health 58:435–447

    Article  PubMed  Google Scholar 

  • Linetzky B, De Maio F, Ferrante D, Konfino J, Boissonnet C (2013) Sex-stratified socio-economic gradients in physical inactivity, obesity, and diabetes: evidence of short-term changes in Argentina. Int J Public Health 58:277–284

    Article  PubMed  Google Scholar 

  • Ma R, Lin X, Jia W (2014) Causes of type 2 diabetes in China. Lancet Diabetes Endocrinol 2:980–991

    Article  PubMed  Google Scholar 

  • Peng X (2011) China’s demographic history and future challenges. Science 333:581–587

    Article  CAS  PubMed  Google Scholar 

  • Ploubidis GB, Mathenge W, De Stavola B, Grundy E, Foster A, Kuper H (2013) Socioeconomic position and later life prevalence of hypertension, diabetes and visual impairment in Nakuru, Kenya. Int J Public Health 58:133–141

    Article  PubMed  Google Scholar 

  • Siegel M, Luengen M, Stock S (2013) On age-specific variations in income-related inequalities in diabetes, hypertension and obesity. Int J Public Health 58:33–41

    Article  PubMed  Google Scholar 

  • Wooldridge J (2010) Econometric analysis of cross section and panel data, 2nd edn. MIT Press, Cambridge

    Google Scholar 

  • Xu Y, Wang L, He J et al (2013) Prevalence and control of diabetes in Chinese adults. JAMA 310:948–959

    Article  CAS  PubMed  Google Scholar 

  • Yang W, Lu J, Weng J et al (2010) Prevalence of diabetes among men and women in China. N Engl J Med 362:1090–1101

    Article  CAS  PubMed  Google Scholar 

  • Yip WC, Hsiao WC, Chen W, Hu S, Ma J, Maynard A (2012) Early appraisal of China’s huge and complex health-care reforms. Lancet 379:833–842

    Article  PubMed  Google Scholar 

  • Yuan X, Liu T, Wu L, Zou Z-Y, Li C (2015) Validity of self-reported diabetes among middle-aged and older Chinese adults: the China Health and Retirement Longitudinal Study. BMJ Open 5:e006633. doi:10.1136/bmjopen-2014-006633

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhao Y, Strauss J, Yang G et al (2013) China health and retirement longitudinal study—2011–2012 national baseline user’s guide. Peking University, Beijing

    Google Scholar 

  • Zhao Y, Smith JP, Strauss J (2014a) Can China age healthily? Lancet 384:723–724

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhao Y, Crimmins E, Hu P, Hu Y, Ge T, Kim J-K, Strauss J, Yang G, Yin X, Wang Y (2014b) China Health and Retirement Longitudinal Study—2011–2012 National baseline blood data user’s guide, School of National Development, Peking University

  • Zhao Y, Hu Y, Smith JP, Strauss J, Yang G (2014c) Cohort profile: the China Health and Retirement Longitudinal Study. Int J Epidemiol 43:61–68

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yaohui Zhao.

Ethics declarations

Funding

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhao, Y., Crimmins, E.M., Hu, P. et al. Prevalence, diagnosis, and management of diabetes mellitus among older Chinese: results from the China Health and Retirement Longitudinal Study. Int J Public Health 61, 347–356 (2016). https://doi.org/10.1007/s00038-015-0780-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00038-015-0780-x

Keywords

Navigation