China must win the battle against diabetes

PUBLISHED : Friday, 06 September, 2013, 12:00am
UPDATED : Friday, 06 September, 2013, 3:29am

It has long keen known that lifestyle diseases associated with increasing affluence have rapidly changed China's national health profile. But that has not prepared anyone for the shock delivered by the most comprehensive survey yet of the prevalence of diabetes. A survey of nearly 100,000 Chinese showed the incidence among adults has risen from less than 1 per cent in 1980 to 11.6 per cent in 2010 - higher than the 11.3 per cent of Americans over 20 found to be diabetic in 2011 data.

American projections, if applicable to China, put the issue in terrifying perspective. US authorities say that if current trends continue, one in three Americans will have diabetes by 2050. A similar scenario among China's 1.36 billion people would be nothing less than catastrophic. Health experts already use that adjective to describe the ratio of the 114 million Chinese diabetes sufferers to the global total - one in three.

The research, published in the Journal of the American Medical Association, was led by Guang Ning, from the laboratory for endocrine and metabolic diseases at the Ministry of Health. It found the young and middle-aged were most at risk, and for every mainlander diagnosed with diabetes two more were unaware they had it.

The risks include heart and kidney disease and stroke. An accompanying article by Juliana Chan of the Chinese University of Hong Kong said China's modernisation contributed to diabetes through food abundance, physical inactivity and "psychosocial stress".

Even given the foregoing factors, how could it have come to this so quickly? There are some possible factors peculiar to Asia or China, such as poor nutrition in early life and overeating later, and the greater susceptibility of Asians to diabetes. Both may also help explain why those in the Chinese study, unlike American diabetics, are not overweight.

If there is a silver lining in this cloud, it may be found in the experience of Hong Kong, where the incidence of diabetes peaked at 10 per cent in the 1990s before falling back to 7 per cent in the most recent survey in 2004, as people became more health-conscious about their diet and lifestyle.

The mainland authorities need to devote unlimited resources to reproducing this effect through a health education campaign. They should expand it to include smoking, which compounds the effects of diabetes as well as exacting its own toll, and help pay for it by raising the excise duty the government collects from its tobacco monopoly.