Diabetes in China: a societal solution for a personal challenge

被引:316
作者
Chan, Juliana C. N. [1 ,2 ,3 ]
Zhang, Yuying [1 ]
Ning, Guang [4 ]
机构
[1] Chinese Univ Hong Kong, Prince Wales Hosp, Dept Med & Therapeut, Shatin, Hong Kong, Peoples R China
[2] Chinese Univ Hong Kong, Prince Wales Hosp, Hong Kong Inst Diabet & Obes, Li Ka Shing Inst Hlth Sci, Shatin, Hong Kong, Peoples R China
[3] Chinese Univ Hong Kong, Prince Wales Hosp, Int Diabet Federat Ctr Educ, Shatin, Hong Kong, Peoples R China
[4] Shanghai Jiao Tong Univ, Shanghai Clin Ctr Endocrine & Metab Dis,Sch Med, Natl Clin Res Ctr Metab Dis,E Inst Shanghai Univ, Key Lab Endocrine & Metab Dis,Minist Hlth,Ruijin, Shanghai 200030, Peoples R China
关键词
LIFE-STYLE INTERVENTION; ALL-CAUSE MORTALITY; RISK-FACTORS; SELF-MANAGEMENT; GLYCEMIC CONTROL; GLUCOSE REGULATION; THRIFTY PHENOTYPE; VASCULAR-DISEASE; ADULT-POPULATION; RENAL-DISEASE;
D O I
10.1016/S2213-8587(14)70144-5
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
China has a large burden of diabetes: in 2013, one in four people with diabetes worldwide were in China, where 11.6% of adults had diabetes and 50.1% had prediabetes. Many were undiagnosed, untreated, or uncontrolled. This epidemic is the result of rapid societal transition that has led to an obesogenic environment against a backdrop of traditional lifestyle and periods of famine, which together puts Chinese people at high risk of diabetes and multiple morbidities. Societal determinants including social disparity and psychosocial stress interact with factors such as low-grade infection, environmental pollution, care fragmentation, health illiteracy, suboptimal self-care, and insufficient community support to give rise to diverse subphenotypes and consequences, notably renal dysfunction and cancer. In the China National Plan for Non-Communicable Disease Prevention and Treatment (2012-15), the Chinese Government proposed use of public measures, multisectoral collaborations, and social mobilisation to create a health-enabling environment and to reform the health-care system. While awaiting results from these long-term strategies, we advocate the use of a targeted and proactive approach to identify people at high risk of diabetes for prevention, and of private-public-community partnerships that make integrated care more accessible and sustainable, focusing on registry, empowerment, and community support. The multifaceted nature of the societal and personal challenge of diabetes requires a multidimensional solution for prevention in order to reduce the growing disease burden.
引用
收藏
页码:969 / 979
页数:11
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