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1、1,The Rising Challenge of Diabetes in China,Chang Yu Pan Department of Endocrinology, Chinese PLA General Hospital Chinese PLA Endocrinology and Metabolism Centre and Key Laboratory Apr.11- 2008,2,Medical and Health Annual Encyclopaedia Britannica, 1999,3,3,Death from Diabetes 2.90 Million (5.2%of t
2、otal mortality) Worldwide: 1 of 20 death is from diabetes (About 8,700 death /day or 6 death/min) About 1 of 4 death is DM in Asia-Pacific RegionDeath from AIDS: 3.0 Million,What AIDS was in the last 20 years of the 20th century, diabetes is going to be in the first 20 years of this century,Roglic e
3、t al, 2005,The Rising Challenge of Diabetes,4,Lifestyle changes, Urbanization and Longevity in China,National Nutrition and Health Survey (1982 2002) Carbohydrate +10% , Meat +57% eggs +69% Total Carloria:2254cal./person/day,5,Prevalence of overweight / obesity in China (20-70 years),Overweight/ obe
4、sity (BMI 25 kg/m2) (WHO criteria),Data from National Nutrition Survey (1992), the Working Group on Obesity in China (2002),Age-standardized Prevalence (%),6,Prevalence of overweight/obesity in Chinese children & adolescents (2002),Data from 2002 National Nutrition and Health Survey,WGOC criteria,%,
5、7,Prevalence of overweight/obesity in Chinese children & adolescents (1985- 2000),Ji C et al, Chinese Journal of Epidemiology 2004,8,9,Global prevalence of diabetes *,In 2007, the five countries with the largest numbers of people with diabetes are: India, China, United States, Russia, Germany By 202
6、5, the largest increases in diabetes prevalence will occur in low- and middle-income countries Each year an additional 7 million people worldwide develop diabetes,* Diabetes Atlas, 3rd edition, International Diabetes Federation, 2006,10,Peoples Republic of China,Prediabetes 2003 33 million (4%) 2025
7、 54 million (5%),Diabetes 2003 23 million (3%) 2025 46 million (4%),Sicree, Shaw, Zimmet. Diabetes Atlas. IDF. www.idf.org.2006,The prevalence of DM is increasing rapidly,11,Growing prevalence of diabetes and prediabetes in China,National Diabetes Research Group. Chin J Int Med 20:678,1981 Pan XR, e
8、t al. Diabetes 20:1664, 1997; Gu D, et al. Diabetologia 46:1190, 2003,*Screening with FPG only,12,Prevalence of IGT in all age groups was higher than that of Diabetes,Prevalence of IGT and Diabetes in 11 provinces, China,Chin J Epidemiol. 1998;19(5):282-285.,13,Shanghai Diabetes Institute,Isolated f
9、asting DM: 0.6%,Isolated post-challenge diabetes: 2.4%,Combined DM:1.9%,Total prevalence of newly diagnosed DM:4.9%,Total prevalence of prediabetes: 11.7%,Isolated IGT 8.8%,Isolated IFG 1.7%,IFG + IGT 1.2%,75%,15%,10%,Jia WP et al.Dibetologia 2007,Isolated post-challenge DM and IGT Common in China,1
10、4,Newly diagnosed diabetes (OGTT),33%,3%,23%,24%,17%,36%,37%,27%,OGTT cohort (n=2,263),Whole population (n=3,513),2/3 of patients have hyperglycaemia,3/4 of patients have hyperglycaemia,Previously known diabetes,Newly diagnosed diabetes (FPG test),NGT,Prediabetes,Hu DY, Pan CY,Yu DM. Eur Heart J 200
11、6;27:25739.,China Heart Survey dysglycemia is common in patients with CAD,15,WP Jia, et al. Diabetologia, 2006(in press),Epidemiological characteristics DM and IGT in a Chinese adult population: the Shanghai Diabetes Studies (SHDS),Prevalence(%),Incidence(%),three-year cumulative incidence rates,inc
12、idence rates per year,1999-2001, n=5628,2002-2004, n=2709,16,Chinese individuals with IGT progress to type 2 diabetes faster than American individuals with IGT,Chinese IGT population is at high risk of DM,Pan XR, et al. Diabetes Care 1997;20:53744. Knowler WC, et al. NEJM 2002;346:393403.,17,Da Qing
13、 IGT intervention Study577 IGT519 Control4% IGT0.4% NGT,The appearance of ECG consistent with CHD,IGT and the risk of CVD,Diabetes Care 1993:16.150-156,18,IGT and Atherosclerosis - Study from PLA General Hospital in China,*,*,*,IGT,NGT,DM,IGT,IGT,NGT,NGT,DM,DM,N: 97(NGT), 51(IGT), 73(DM) Adjusted by
14、 age and sex * P0.05, P0.005, v.s. NGT,Jing WS, Pan CY, Lu JM, et al.Chin J Endocrinol 20(2):136-139,19,The cumulative rate of CVD,Coxs Proportional Harzard Model,Xu Xj, Pan CY Tian H.et al, Chin J Gerontol.2001.,0.97,0.98,0.99,1.00,1,2,3,4,Year,NGT,IGT,DM,The CVD Risk of IGT and Diabetes- Study fro
15、m PLA General Hospital in China,Cumulative rate,0,20,CODIC2 Control of Type 2 Diabetes in China,Biao X, Pan CY, Ji LN, et al. CODIC2, 2007, in press,N=1530,N=2054,N=524,21,Surveillance of Type 2 Diabetes in China,2001 hospitals distribution: Grade 3: 32(65%), Grade 2: 17(35%) 2006 hospitals distribu
16、tion: Grade 3: 43(72%), Grade 2: 16(27%), Grade 1: 1(2%),Patient Population,22,BMI,Anti-obesity Treatment: 2001 2003 20061.5% 1.0% 1.0%,BMI was analysed for patients 18 years only,24.6,24.3,24.0,23.7,10,15,20,25,30,1998,2001,2003,2006,BMI (kg/m2),Pan CY. Intern Journ Endocr. & Mtab. 2005, 25 (3): 174-178.,23,WAIST,90.8,87.2,80,
