Prevalence and Risk Factors of Diabetes Among Adults Aged 45 years or Older in China: A National Cross-sectional Study

Background: Although there is preponderance of literature on disease burden of diabetes in developed countries, limited investigations have been conducted in less developed regions including China. This study aimed to explore the current prevalence and risk factors for diabetes, pre-diabetes, awareness, treatment and control of diabetes in China.

Methods: We included 12,458 adults from the China Health and Retirement Longitudinal Study. We estimated prevalence of diabetes and pre-diabetes in the overall sample and by socio-demographics. Bivariate associations of diabetes, pre-diabetes, awareness, control and treatment of diabetes with health and function measures were evaluated by chi-squared test and multivariate logistic regression analysis.

Results: We found that the prevalence of diabetes and pre-diabetes was 13.21% and 25.16%. The prevalence of diabetes increased with advanced age (12.37%, 15.98% and 16.52% among persons who were 45 to 55, 55 to 65 and ≥65 years old, respectively), educational background (14.52%, 15.52% and 15.58% among persons who were illiterate, had primary education and had secondary or above education) and weight (8.18%, 17.05% and 22.54% among persons with a body mass index of 18.5 to 24.9, 25.0 to 29.9 and ≥30.0, respectively). The prevalence of diabetes was higher among urban residents than among rural residents (19.04% vs. 12.85%). We also observed that aged between 55 and 65 years, obesity, history of hypertension and coronary heart disease, and inactivity were significant risk factors of awareness of diabetes.

Conclusion: Our results indicated that diabetes is high prevalent in adults aged 45 years or above in China. The potentially modifiable risk factors should be further studied to develop interventions and strategies aimed at prevention and treatment of diabetes among middle-aged and older Chinese adults.