Prevalence, diagnosis, and management of diabetes mellitus among older Chinese: results from the China Health and Retirement Longitudinal Study

Objectives To estimate prevalence of diabetes mellitus (DM), success in diagnosing, and methods of diabetes management in China. Methods China Health and Retirement Longitudinal Study, a representative survey of the Chinese population at least 45 years old, is used to estimate diabetes and prediabetes prevalence, diagnosis, and treatment and their associations with residence, socioe-conomic, and demographic factors. Results Almost 60 % of middle-aged and elderly Chinese have prediabetes or diabetes in 2011-2012. DM prevalence increases with age, but the oldest group is least likely to be diagnosed. Prevalence is higher with higher body mass index, fasting cholesterol, and larger waist circumference. Higher prevalence is found in urban areas among residents with urban registration status (the Chinese administrative registration system or hukou), especially in coastal regions. Better rates of diagnosis, management, and education regarding diabetes are strongly associated with urban hukou, living in coastal areas, and in families with higher per capita expenditures, the appropriate economic resources measure in China. Conclusions Diagnosis and management of diabetes is highly differential within China but recent efforts to improve health systems are succeeding in reducing undiagnosed disease. Current high prevalence of prediabetes suggests a more intensive effort is required in the future.