A diabetes epidemic is upon us, despite improved knowledge and therapy on this disease. The recently published 6th edition of the International Diabetes Federation Atlas provides some alarming figures.

Head of Diabetes Research Program, Puhong Zhang, pictured with the DOSA study team

Head of Diabetes Research Program, Puhong Zhang, pictured with the DOSA study team

It estimates that 8.3% of people worldwide have this disease, to grow to 10% in 2035. 80% of them live in low to middle income countries. In China and India alone, there are 163.5 million people with diabetes, to grow to 251.7 million people in 2035. Healthcare spending is expected to increase from USD548b to USD627b in 2035. Puhong Zhang, Head of Diabetes Research Program of George Institute China, talks about some of our current work in that region to address the ever increasing burden of diabetes.

“There are 11 team members in our program, including Prof JI Linong, Vice President of International Diabetes Federation and Ex-President of Chinese Diabetes Society who was appointed as the Chief Scientist. Our team also includes a head of department and 9 researchers and program administrators”.

Since the department has been established, the scientific research work mainly includes:

  • A preliminary investigation on describing coverage, cost and care of type 1 diabetes in China, (3C): this study, which is collaborated between the International Diabetes Federation (IDF) and the Chinese Diabetes Society (CDS), aims to build a comprehensive evidence base of the coverage, cost and care of Type 1 Diabetes in China. This sophisticated designed study covers 3 major areas of epidemiology, health economics and health service, taking place in 21 secondary hospitals and tertiary hospitals in Beijing and Guangdong. The study outcomes are consecutively published. The main results from 3C study were reported on West-Pacific Regional Conference of IDF in November 2012, and the abstract was published on the Journal of Diabetes Investigation.
  • Observational Registry of Basal Insulin Treatment (ORBIT) Study in type 2 diabetes patients uncontrolled by oral antidiabetic drugs: this study, which is co-initiated with CDS, focuses on the real world use, effectiveness and safety of initial basal insulin regimen in type 2 diabetic patients and aims to bring the first-hand data for guiding the scientific use of basal Insulin in China. This study was initiated in November, 2011. More than 210 secondary hospitals and tertiary hospitals in China took part in this program. Currently total 20000 patients with type 2 diabetes have been enrolled, and the 6 months follow-up will be completed in March, 2014.
  • Diabetes and Obstructive Sleep Apnea in China (DOSA Study): this study, which is co-initiated with Peking University People’s Hospital, aims to investigate the prevalence of Obstructive Sleep Apnea Syndrome (OSAS) for hospitalized patients with type 2 diabetes in China and the correlation between OSAS and the diabetic complications and comorbidities, and provide references for the diagnosis and treatment of OSAS for hospitalized patients with type 2 diabetes. 12 centers from six regional representative cities in China took part in this study, and 884 patients finished their cross-sectional investigations. The preliminary results show that among the hospitalized type 2 diabetes patients, 60% of them have OSAS.
  • Comprehensive Management Program for Community-Based Type 2 Diabetes Patients: this is a population controlled study sponsored by Beijing Municipal Commission of Science and Technology. Peking University People’s Hospital is responsible for this program, while The George Institute for Global Health at Peking University Health Science Center participates in the study’s design and implementation. This program will organically integrate the selection and intervention of high-risk patients, patient management and health economic evaluation, with aim of developing the comprehensive model for preventing and controlling diabetes in the local community.

“Although China’s economy has seen unprecedented growth, some problems such as relatively weak health awareness amongst its people and severely inadequate allocation of health resources remain. This has led to an increase in various chronic diseases such as obesity, high blood pressure, diabetes, as well as their complications and comorbidities. In the past 30 years, the prevalence of diabetes in Chinese adults has increased from 1% to 10%. China’s government needs to make great efforts not only to improve the control of diabetes, but also to lower the incidence of diabetes. National studies show that nearly 70% of diabetes patients remain undiagnosed, 50% of Chinese adults are pre-diabetic and nearly all of them are unaware of this situation, let alone take action on their condition. With such staggering numbers, diabetes and its complications and comorbidities will bring unmeasurable burden to China should there be no significant achievement in diabetes control or prevention”.