Prevalence of diabetes and impaired fasting glucose in the Chinese adult population: International Collaborative Study of Cardiovascular Disease in Asia (InterASIA)

Aims/hypothesis. To estimate the prevalence of diagnosed and undiagnosed diabetes and impaired fasting glucose in the general adult population of China. Methods. The International Collaborative Study of Cardiovascular Disease in ASIA, conducted from 2000 to 2001, included a nationally representative sample of 15 540 adults, aged 35 to 74 years. An overnight fasting blood specimen was collected to measure serum glucose and information on history of diabetes and use of hypoglycaemic medications was obtained by a standard questionnaire. Undiagnosed diabetes (fasting glucose greater than or equal to7.0 mmol/l) and impaired fasting glucose (6.1-6.9 mmol/l) were defined using the American Diabetes Association criteria. Results. Prevalence of self-reported diagnosed diabetes, undiagnosed diabetes, and impaired fasting glucose in Chinese adults were 1.3%, 4.2%, and 7.3%, respectively. Overall, 5.2% or 12.7 million men and 5.8% or 13.3 million women in China aged 35 to 74 years had diabetes (self-reported diagnosis plus undiagnosed diabetes). The age-standardized prevalence of diabetes was higher in residents of northern compared to southern China (7.4% vs 5.4%, p<0.001) and in those living in urban compared to rural areas (7.8% vs 5.1%, p<0.001). Conclusions/interpretation. Our results show that the prevalence of diabetes in the adult population in China is much higher than previously reported. Three out of every four diabetes patients are undiagnosed, indicative of a lack of population-based screening programmmes and a relatively rapid and recent increase in incidence of diabetes. These results indicate that diabetes has become a major public health problem in China and underscore the need for national strategies aimed at prevention and treatment of diabetes.