Diabetes in Shenzhen, China: epidemiological investigation and health care challenges

BACKGROUND Understanding epidemiological characteristics of diabetes in a specific population will potentially benefit prevention and control of diabetes and policy-making. This study aimed to investigate the prevalence and awareness of diabetes, as well as its pharmacological, non-pharmacological and primary care management in Shenzhen, China. METHODS A cross-sectional study was conducted. We employed multistage cluster random sampling methods to select the participants. Face-to-face interview surveys were conducted to collect data. A total of 1676 participants completed the survey. RESULTS We found that the prevalence of diabetes was 4.8%. The prevalence of impaired fasting blood glucose was 6.0%. The prevalence rates of both diabetes and impaired fasting blood glucose increased with age (P < 0.001), whereas hypertension was strongly associated with diabetes only (odds ratio (OR) = 1.93, 95% confidence interval (CI) 1.15-3.22). The awareness of diabetes was poor (51.9%) and 54.3% of diabetic patients were not being treated pharmacologically. Less than one-third of diabetic patients were undergoing non-pharmacological treatments. Primary care management of diabetes was recorded for only 11.1% of the patients. CONCLUSIONS Although diabetes prevalence in Shenzhen is about a half that of the Chinese average, high prevalence of impaired fasting blood glucose imposes a public health threat and burden to the health care system. Approximately half of the subjects with diabetes are undiagnosed. Our findings highlight the need of public health efforts for primary and secondary prevention, as well as early detection of diabetes. Primary care may be crucial an improved access to medical services and better management of diabetes.