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November 16, 2010

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1 in 10 Chinese adults likely to have diabetes

CHINA is facing an epidemic of diabetes. It has more diabetic patients than any other country, 92 million, and another 150 are well on their way to developing it. Around one in 10 adults has diabetes. Most cases are undiagnosed.

These findings were reported in the New England Journal of Medicine last March, based on a nationally representative sample of more than 42,000 people tested for diabetes.

In 2007, China had 40 million diabetic patients.

Most diabetics live in cities and most are overweight. The International Diabetes Federation announced that China has the highest number of cases. Sunday was World Diabetes Day.

Prevention and lifestyle changes can reduce the risk and rate of diabetes.

Although insulin is known as the major treatment for diabetes, experts say it prolongs the life of diabetics, but does not improve the situation. Prevention is more important and less costly than treatment, observed Dr Zou Dajin, chief of endocrinology at Shanghai Changhai Hospital.

"Diabetes is not fatal, but the complications are usually more dangerous than diabetes itself," says Dr Zou. "About 75 percent of diabetes patients die of cardiovascular disease, which is a typical complication."

Other complications also include kidney problems, blindness and peripheral arterial disease. According to Dr Zou, in every minute, about 40 diabetes patients die of cardiovascular disease, 12 patients go blind, seven suffer kidney failure and four legs of the patients are amputated due to peripheral arterial disease.

"Diabetes is irreversible once it happens," says Dr Zou. "Therefore, prevention is crucially important and deserves wide public awareness."

According to a Chinese saying: The top and best doctors treat wei bing (disease that has not struck), the middle-level doctors treat yu bing (disease about to happen), and the lowest level of ordinary doctors treat yi bing (disease itself).

Three levels of care are recognized:

In healthy and pre-diabetes people: controlling risk factors, such as weight, high blood pressure, cholesterol, blood fat, blood sugar, poor cardiovascular health.

In diabetes patients: controlling risk factors and taking medication to prevent complications.

In patients with complications: trying to prevent aggravation, which is difficult and costly.

Awareness of risk factors is essential to prevention, notes Dr Zhou. Overweight is a danger sign (males with waist measurements above 90cm, females above 85cm).

Other factors are family history of diabetes, smoking, high blood sugar in pregnancy and giving birth to a baby heavier than 4kg. Age is another factor as metabolism slows and people become less active. Risk usually increases by 20 percent every 10 years after the age of 40.

"If you have any warning signals and at least one of the risk factors, you are among the high-risk group that needs high alert and prevention," says Zhou. "If you have just a few risk factors, it's better to control them and make lifestyle changes in diet, exercise and so on."

Those with risk factors should eat a small dinner, since most calories won't be burned but will be stored as fat. Eating half or a third of the amount of lunch is recommended.

Regular physical exercise is essential and a walk or jog after dinner can help burn calories.

Monitoring blood sugar every six months is recommended.

Diabetics with no complications need to monitor and lower blood sugar, blood fat, cholesterol and blood pressure (below 90/130mmHg). Losing weight and quitting smoking are essential for cardiovascular health. Watch the dinner and exercise regularly.

Some doctors prescribe aspirin, a blood thinner, to help prevent cardiovascular problems; people should consult their doctor about whether they should take aspirin.

Taking around 100mg aspirin every day can significantly help reduce cardiovascular disease and death, says Dr Shen Weifeng, chief of cardiology at Shanghai Ruijin Hospital.

It should be taken on a full stomach as aspirin can irritate the stomach lining over a long period. Enteric-coated tablets usually have fewer side effects, but ay cause more gastric acid secretion.

Patients with ulcers and bleeding in the digestive system should avoid aspirin.


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