As the world marked the 22nd World Diabetes Day yesterday, it was eerily silent on the mainland - the country with the largest number of diabetes patients.
Experts said the country lacked state-level advocacy and systematic prevention to keep the disease under control - and mainland experts could not even agree on the number of sufferers.
A new study published in the Journal of American Medical Association by a team of Chinese experts suggested that 11.6 per cent of Chinese adults have diabetes. The Chinese Centres for Disease Control and Prevention, however, still listed 9.7 per cent as the official diabetes occurrence rate.
The disparity has triggered much discussion since the release of the JAMA study, which used the diagnosis standard adopted by the American Diabetes Association in 2010, which includes glycated hemoglobinA1c (HbA1c) as one of three criteria to identify diabetes patients.
The CDC, on the other hand, is using the 1999 WHO standard that only tests two criteria: fasting plasma glucose and two-hour plasma glucose.
Some expects said they suspected the adoption of a more conservative standard indicates that public health authorities may not want to report a higher figure to the public as it will indicate its failure to prevent the disease from spreading. It could also put pressure on the government to put more resources into public medical care.
Professor Liu Zunyong, director of Jindian Diabetes Hospital in Beijing, said that the ADA standard was recommended by the WHO in 2011 and was widely used in the United States and some parts of Europe.
Liu said the costs might be the reason behind Beijing's decision to stick to the 1999 WHO standards. Testing HbA1c is expensive and mainland hospitals may not have the resources to widely adopt it.
While using the conservative government data, diabetes has spread at an alarming speed on the mainland due to lifestyle changes.
In 1979, the diabetes occurrence rate was just 0.67 per cent. By 1996, it had grown to 3.2 per cent.
Professor Ning Guang, who supervised the JAMA study, said decision-makers must have the courage to face the truth.