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China's diabetes rate passes 11 percent

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China now holds the dubious distinction of having not only the highest number of diabetes cases of any country in the world, but also having the highest percentage incidence rate.

A clinical study recently published in The Journal of the American Medical Association (JAMA) reports diabetes rates in China have reached 11.6 percent in the adult population. The study, conducted in 2010, analyzed data collected from nearly 99,000 participants. It estimates just over 12 percent of men and 11 percent of women in China suffer from the disease. Combined, these percentages represent 113 million people.

Diabetes — called tangniaobing (糖尿病) in Chinese — was not the only focus of the report. Researchers also found that prediabetes rates in the country have skyrocketed. The JAMA findings say that as many as 493 million people suffer from abnormal blood sugar levels that can be a precursor to developing the disease.

As recently as 1981, diabetes was barely a concern in China, reportedly affecting less than one percent of the population. The spectacular increase in cases has often been linked to China's economic rise, and concurrent rise in consumption, over the past 30 years.

Although scientific studies have not conclusively established such a connection, rates of non-communicable diseases such as diabetes are now much more prevalent in developed countries whose populations eat high-calorie diets and have more sedentary workforces. The JAMA study of China concluded residents living in China's "cities and economically developed areas" were more likely to develop the disease than rural residents.

GoKunming spoke with a doctor surnamed Xiong at the Yunnan Provincial Hospital of Traditional Chinese Medicine (云南省中医医院), which maintains a diabetes ward where treatments from Traditional Chinese and Western medicines are often used in tandem.

Although reticent to speculate on current diabetes numbers for either Kunming or Yunnan, Xiong explained that in her experience the number of people seeking treatment for the disease has risen noticeably. She also agreed with findings put forth in the JAMA findings, saying many people — according to the JAMA report 75 percent — receive no treatment for the disease.

We can treat it here when people come to the hospital. Kunming has several medical centers with wards devoted to diabetes, but rural areas in the province often lack doctors with adequate training or don't have access to medicine like insulin.

Shortly after the JAMA report was released, news service Bloomberg estimated the cost of treating everyone in China with diabetes could surpass US$22 billion annually.

Image: Al-Jazira

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I recall 15 years ago seeing very few overweight people in China. Now it's an entirely different story.

Yes, when I first came to China 10 years ago I would maybe see one morbidly obese person, usually a pre-teen, about once per month. Now I see many more daily, and I also see more morbidly obese adults. You can't blame this all on western fast food.
I will use about 5 ltr of oil per year, mostly for baking bread, and less than 1 ltr for frying food. I see a neighbor coming home from the supermarket with that much every week.
People also think Asians are skinny because they eat rice. But rice is a simple carb. Lots of rice leads to fat. Add to that all the oil and sugar.

As for sedentary life, it is a problem, but 11% of the popn. do not live a sedentary life.

We eat so much more complex carbs in the West. Historically the Chinese diet has been more aligned to paleo (vegetables, fruit and some meat/fish); hence their relatively good health and fitness. As soon as the golden arches arrived it was the start of the obesity epidemic. I wouldn't be so concerned about fat and exercise, more about sugar, wheat and complex carbs in all the processed food. Stop eating these and I think you will have gone a long way to stopping this getting out of control in China. I appreciate it's easier said than done.

Sorry, disagree with tiger. Frying food and the amount of cooking oil used hasn't really changed and therefore isn't the problem. I'm not sure I'd blame rice either because it's been part of their diet since the beginning of time.

So therefore, one needs to look at the factors in the food supply that have changed. In my opinion, all roads lead to coca-cola and KFC. Not to mention baked goods, which were non-existent.

Agree with Marco Polo. The closer you stay to a Paleo diet, the less likelihood of diabetes.

I agree that the problem is related to the moving away from the Paleao diet. The big shift seems to be more meat (they love high fat cuts), more oil, more noodles, and perhaps more than anything more rice.
Western fast foods, do not exist in my wife's hometown, diabetes, is a major problem there too. The people are also more active than I see in Kuming. The key change in their life has been more affluence.

The population is eating a lot more food generally than they did before. Blaming obesity on western fast food is easy, but I am not sure there is solid causality. Western fast-foods arrived arrived at the same time as more affluence.

The affluence coincided with more processed foods (a western style diet, but not fast foods, or western corporations). Perhaps it would be fairer to call this a developed countries bad diet.

In the supermarket we can see how much store space is dedicated to high fat,high sugar, snacks. These are mostly home market products. Some of the local drinks are much more prevalent than Coke, and have more sugar in them. For the supermarket it is a no brainer what to give shelf space to, as these foods all have high profit margins.

Buying oil and meat used to be a luxury. Now everyone can afford much larger portions, and more frequent consumption of both. My mother in law will admit to consuming more meat in some meals now than she used to get in a month. In the past her main source of oil was rendered animal fats, vegetable oil was store bought and rare.

I see my kids in school. Half of them have parents who understand nutrition, and the kids are consuming a Paleo diet. The other half consume a lot of high carb snacks between meals and eat huge portions of rice and oily foods at the canteen. WangLaoJi is seen as a semi-medicinal stimulant.
Or could draw a correlation between student diet and performance, but that would be unreliable as the kids on a healthy diet have parents who seem to make better choices generally. The educational attitude may also reflect the family values.

The advice (Tao) from thousands of years ago that to live longer give up the grain and eat less meat is as valid today as it was then.

A new study (Nutritional Science Initiative) NuSi hopes to explore the effect of the Standard American Diet (SAD) that is 50% carbohydrate 15% protein and 35% fat with a more ketogenic approach of 5% carbohydrates and 15 % protein and 80% fat.

These types of studies should shed light on the effect to glucose levels, insulin response levels, and ketone levels that might stop and or reverse the effects of high sugar and grain diets. (Is it just the sugar (mostly fructose effect) or all glucose elevating carbohydrates and even exessive amounts of protein via gluconeogenesis?

And even all fats are not alike. I think if Ben Franklin could not eat it then we should not or at the very least be a skeptic. Modern high temperature man made soy, corn, canola, and cotton seed oils from back to the Nepoleonic era and forward need to take a back seat to lard, tallow, and for westerners butter and cream.

PS My fasting blood sugars are under 83 mg per DL and AIC below 4.5 MM so the proof is in the diet. (Mine is high fat and moderate protein with a few vegetables. Hint (No grain and no sugars)

Eric

The big problem is, the increase of white rice intake...its all converted to sugar. Im not a health expert, or a genius. But that is my opinion.

This year, the W.H.Org. shows that there are more "overweight problem" than "malnutrition issues"... the world is changing ...

As I consider the increase of diabetes in China there is only one clear reason. If fast food was the culprit, the USA would certainly have more than 11.6% of its population diagnosed with diabetes. More and more Chinese are eating KFC, Pizza Hut, and McDonalds; however, the amount of people consuming food from these establishments is still a very small percent compared to the entire population. Therefore, you can probably blame some of the obesity problem on these joints; however, you can't blame the rapid increase of diabetes on them.

Instead, it is clear to me that alcohol a tobacco use is the clear reason there has been a rapid increase of diabetes in China. China has more smokers than any other country in the world—by a long shot. Americans eat way more fast food than Chinese, but tobacco in the USA is a fragment of what is used in China. Unlike those who consume fast food in China, citizens from all socioeconomic statuses smoke in China. Smoking is the common link.

If you don't believe me, check out what the mayo clinic says about smoking and diabetes. www.mayoclinic.com/health/diabetes/AN00548

No mention of the average age of the people with diabetes. In the west, people have adapted to GMO and junk food over time (70 years) but in China the junk food revolution has ocurred in a very short period of time. Much in the same way as Native Americans became alcoholic in a short period of time because alcohol was introduced by the murdering Europeans that came to occupy and steal their land.

China got way more junk food at around the same time that they got elevators, electric scooters, cars, escalators and more affluence. Poor eating habits combined with heavily reduced activity have obviously taken their toll, and it's probably going to get worse before it gets better :-s

All of the above combined with Asian genetics = more diabetic friends.

Of what I have seen the problem lies in the amount of sugar used in cooking rather than the amount of junkfood consumed (which tends to be very high in salt). People don't like too much sugar as in pure sugar or sugar in drinks and snacks, yet if you see how much they use in cooking (they put in bread, sticky rice milk, etc. too), my goodness how much that is.
Many dishes people like to eat are very high in sugar content. Orange Beef has a ton of sugar as far as I know. But it's soo tasty!

half the snacks in china are sugar snacks. yes there are salt snacks too, but many are sugar. little jellows, candy, cookies, orion pies, cakes, and soda, or redbull to wash it down. Hell event he bread is full of sugar. diabeties also is about hight fat, any rich and high cal foods are part of the problem. And lots of alchohol sweet drinks now too.

Before a knee jerk blame fat response maybe some enlightened reading?
Kichard K Berstein MD on this subject:
Taubes on why get fat
Lustig on sugar (Fructose)
Wheat Belly

Visit the Swedish web site www.dietdoctor.com

Just for a start: Eric

The difficulty is putting it into practice on a daily basis.
Most restaurants do not follow any kind of health principles whatsoever, so you have to cook yourself if you truly want to avoid unhealthy foods.

fat is part of the problem, before knee jerk blame it all on wheat

Its all the hidden sugar, oil, lack of exercise. Good points Dazzer/ Krismoonpie. Tiger, even though there are correlations, a person's weight actually has no reference to type II diabetes. Waist circumference is a better measure (i.e. in layman's terms' the beer gut).

Also China's tea production has increase but per capita consumption decreased. Pu-erh tea is a hypoglycaemic agent, which is in declining per capita consumption. Even though all this is staring the government and medical researchers, medical practitioners in the face, why are things getting worse? Co-morbidities with cancer, heart failure, highly organized urban dwellings and structured society, what better way to control a birth rate than to decrease fertility rates (double the 11%, it takes two to tango, unless the milkman is doing the rounds in your neighborhood); diabetes effects 25% or more of China's population and at the same time reduce life expectancy due to morbid obesity and type II diabetes and associated diseases. I am a medical researcher with a Ph.D. in nutrition and from a herbal (Phytochemistry and Pharmacognosy, 'not black box TCM') and nutritional medicine practitioner working in Yunnan for a medical university in research and affiliated with the Academy of Sciences. Fade diets etc., such as Paleo/ Low carb are exactly that, fads. There is nothing wrong with complex carbohydrates, except laptops and a sedentary lifestyle. Keep a food diary for 3 days and wear a pedometer and you will soon work out what is going on. Also how many people with diabetes consult a trained and qualified nutritionist instead of looking for answers on the internet, or consult a GP sales rep (and they are growing in Chinese hospitals)? Take this tablet and we will keep your symptoms under control. There are literally hundreds of native grown Yunnan food and herbal species that modulate blood sugar and fats. The bottom line is people do not want to eat them. When was the last time you ate Bitter Melon salad? Fenugreek tea? Mmmm, bitter and hard to digest. Or maybe a dash of Gymnema instead of the burger and fries at one of those 'Western cafes' with a 'polluted menu' in Kunming? Have you ever asked for no oil or salt, or sugar in your food here in China? Its like going to war with the chefs. They cannot fathom why someone would not want their food not drowned in pig fat, salt and sugar. Genetic conditioning over multiple generations will 'weed' out the weak and susceptible, keep the Minoans distracted and diseased (easier to control) and Like Americans in the 80's, Soda is it. What about China's booming cafe market and coffee culture a.k.a sugar market. Have you ever measured, is there more coffeee or sugar in that Starpucks Mocachino? Again that invisible syrup you cant see. Maccas, KFC, and their Chinese imitators are raking in the cash, not to mention bogus medical products on the market. Face it, the sheeple of China are breed to be workers, for their growing commercial overlords. Now the country is adopting more technology, Shopping malls, brands, China is shedding 'weight' in functional labor population but keeping a growing majority in a diseased state and reducing their life expectancy. It is an easier way to reduce population within a 30 year time frame. Welcome to affluenza China and social change.

Chicha78, you're a TCM practitioner?

agree with hidden sugar (or high fructose corn syrup) as the main culprit. ketchup, bread, everything has sugar. and i recently discovered that even cigarettes have sugar, as if the 4000 other chemicals weren't bad enough.

there is a link between smoking and diabetes but i don't think it is the sugar. there is sugar in my wooden chair but i won't be eating it as i don't come from guandong. but BASF is researching this.

another factor in the article "As recently as 1981, diabetes was barely a concern in China, reportedly affecting less than one percent of the population." this reported growth could be down to more frequent/better diagnosis.

"Paleo/ Low carb are exactly that, fads. There is nothing wrong with complex carbohydrates"

....but the Chinese diet does not contain complex carbs. It's basically Paleo + simple carbs (noodles, white rice). strangely, western nutritionists push complex carbs, but they're not found in many diets of ancient cultures like china, nor are many complex carbs readily available here (heinz baked beans in silly metal cans at metro notwithstanding).

"As recently as 1981, diabetes was barely a concern in China"
1981 also coincides with this:
www.coca-colacompany.com/[...]
Since opening our Beijing bottling plant in 1981, the Coca-Cola system has spread across the country by way of our 35 bottling plants. Today, The Coca-Cola Company is proud to be China's leading beverage manufacturer.

Mmm complex carbs and native asian foods yams? brown rice? pulses? vegetables? multitude of wild grains? vegetables? add modern corn? whole wheat? barley? oats? not much to choose from then.

The 80s is when people starting owning cars in China, Dazzler. That might have something to do with it.

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