Background: To estimate secular trends and disease burden of diabetes and prediabetes among Chinese adults.
Methods: Three population-based surveys were performed among Chinese adults in Shanghai in 2002-2003 (n = 12 302), 2009 (n = 7414), and 2017 (n = 18 960). Diabetes and prediabetes were defined using the 1999 World Health Organization (WHO) criteria. Cochran-Armitage trend test was used to examine the trends in prevalence, awareness, and glycemic control status. Disability adjusted life years (DALYs) were estimated to evaluate the disease burden of diabetes-related complications using the population attribution fraction approach based on published data.
Results: The age-adjusted prevalence of diabetes increased during the 15-year period (p for trend <.001) and reached 23.0% (95% CI: 22.1 ~ 24.0%) in men and 15.7% (95% CI: 15.1 ~ 16.4%) among women in 2017. The prevalence of impaired glucose tolerance peaked in 2009, whereas that of impaired fasting glucose increased continuously (p for trend <.001). The awareness of diabetes was found to increase and the glycemic control rates decreased over the three surveys. The estimated DALYs of diabetes complications were found to have increased rapidly due to the increasing prevalence of diabetes and the decreasing glycemic control rates.
Conclusions: Prediabetes and diabetes affect a considerable proportion of Chinese adults in Shanghai. Our results highlight the necessary to strengthen the community healthcare system in China to guarantee extensive management of diabetes and prediabetes.
背景:了解中国成年人糖尿病及糖尿病前期的长期变化趋势和疾病负担。 方法:于2002-2003年, 2009年和2017年在上海市开展了3次以人群为基础的调查，分别为12 302人, 7 414人和18 960人。糖尿病和糖尿病前期的定义采用1999年WHO标准。采用Cochran-Armitage趋势检验分析患病率, 知晓率和血糖控制状况的变化趋势。根据已发表的数据，采用人群归因分数法估算伤残调整寿命年(DALYs)，评估糖尿病相关并发症的疾病负担。 结果:15年间，年龄调整的糖尿病患病率明显增加(p for trend<0.001)，2017年男性和女性的糖尿病患病率分别达到22.0% (95%CI: 21.1~22.9%)和14.5% (95%CI: 13.9~15.2%)。糖耐量受损患病率在2009年达到峰值，空腹血糖受损患病率持续上升(p for trend <0.001)。3次调查糖尿病知晓率均有所提高，但血糖达标率均有所下降。随着糖尿病患病率的上升和血糖控制率的下降，糖尿病并发症所造成的DALYs估计值迅速增加。 结论:糖尿病前期和糖尿病在上海成年人中占有相当比例。我们的研究结果提示有必要加强社区卫生服务体系，以保证糖尿病和糖尿病前期的广泛管理。.
Keywords: awareness; diabetes; prediabetes; prevalence; trend; 患病率; 糖尿病; 糖尿病前期; 认知度; 趋势.
© 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.