Diabetes treatment costs China US$25bn per year
23 Nov 2010
Early Data from a study by the Chinese Diabetes Society of the Chinese
Medical Association and the International Diabetes Federation shows 13%
of China’s medical expenditure is directly caused by diabetes.
The study is a follow-up to one recently published in the
New England Journal of Medicine
which found that China had
twice as many people with diabetes than previously estimated.
China has the largest number of people with diabetes in the world at
92.4 million adults, followed by India with 50.8 million.
The study, which reveals the social and economic impact of diabetes,
also indicates that China can prevent dramatic increase of costs
through effective treatment.
Approximately 5,000 people were interviewed between January 2008
and August 2010 in 12 sites for this nationally representative
study. Early results based on 1,920 responses from five sites reveal
the following key findings:
- 13% of total medical expenditure in China is directly caused
by diabetes, costing RMB 173.4 billion or US$25 billion. People
with diabetes in China report 3 to 4 times more in-patient care,
out-patient visits, and emergency room visits than people
without diabetes of the same age and sex.
- These numbers will increase rapidly over the next 10 to 20
years when approximately 50 million Chinese with undiagnosed
diabetes enter medical care, and when they and the 50 million
Chinese with diagnosed diabetes start developing preventable
diabetes complications such as stroke, blindness and kidney
- Health expenditures for people in China who have had
diabetes for 10 or more years are 460% higher than for people
who have had diabetes for 1 to 2 years.
- Urban Chinese with diabetes are, so far, well-protected from
the financial impact of diabetes that often causes destitution
in countries without health insurance systems. 89% of people
with diabetes in the five Chinese cities studied had health
insurance. Only 11% of their total household income was spent on
medical care. However, they spend 9 times more than people of
the same age and sex without diabetes. Persons who have had
diabetes for more than 10 years spent 22% of their current
household income for healthcare.
- Diabetes prevalence is skyrocketing in China. People are
getting diabetes at a younger age. However, China has a window
of opportunity to prevent an epidemic of serious diabetes
complications, which will increase spending dramatically.
Currently, fewer than 5% of Chinese people with diabetes have
experienced stroke, heart attack or heart failure. Less than 5%
report kidney disease, eye surgery, or problems with their feet
or legs. Half the people interviewed use glucose-lowering drugs
but few use anti-hypertensives (16%), statins (1%), or aspirin
(13%) which are inexpensive and highly effective and can
together lower the risk of complications by 50% or more.
- More than half of Chinese men with diabetes smoke. Smoking
increases the risk of diabetes complications by 2 to 4 times.
“The government of China is dedicated to diabetes care and
prevention. We have introduced several programmes to raise public
awareness of diabetes through education and train community-level
healthcare professionals in diabetes care,” said Madame Kong Lingzhi,
Deputy Director-General, Bureau of Disease Prevention and Control,
Chinese Ministry of Health.
Underlining the importance of the IDF-CDS study on the social and
economic impact of diabetes in China, IDF President Jean Claude
Mbanya said its findings are further proof that diabetes represents
a major barrier to development in low and middle-income countries,
as well as emerging economic powerhouses.
Jean Claude Mbanya said, “The stellar economic development in
countries such as China and India can come with a deadly price tag:
lifestyle-related risk factors for type 2 diabetes, heart disease,
cancers and other non-communicable disease (NCDs).
“This study is an eye-opener and a wake-up call to governments
around the world. In order to protect future generations and ensure
sustained economic success, countries must embrace development
models that include plans for long-term public health.”
One of the main recommendations of the study is that the
cost-effectiveness of existing medical treatments for diabetes be
assessed in China. “This will further improve the efficiency of
China’s healthcare system and make medicines more affordable for
Chinese citizens,” said Prof nong Ji, President, Chinese Diabetes
ThThe Chinese Ministry of Health has introduced large-scale
diabetes awareness and education programmes, driven by the Chinese
On October 20 this year, a three-year project to train 100,000
community-level doctors across the country in diabetes prevention
and treatment was launched. The project also features a web-based
learning platform expected to deliver diabetes training to over
400,000 subscribers every year. Another project launched on October
5 will provide training in glucose management for 1,000
community-based healthcare providers.
In Tianjin, IDF runs a US$400,000 research project, named
BRIDGES, in which the Tianjin Women and Children’s Health Centre
aims to translate a proven gestational diabetes care protocol into
To mark World Diabetes Day, China planned an impressive range of
activities leading up to November 14, including a
government-recognized Standard Injection Day, and diabetes screening
and awareness programmes for the general public in 18 cities.
Monuments in more than 27 Chinese cities, such as the National
Theatre (The Egg) in Beijing and the Oriental Pearl TV Tower in
Shanghai, lit up in blue for the first time on November 14 to mark
World Diabetes Day. The Chinese Diabetes Society has distributed
200,000 blue circle pins, blue measuring tapes and education
booklets, 90,000 posters and flash broadcasts in the waiting room of
railway stations in 343 cities across China. The diabetes blue
circle is the international symbol for diabetes, like the red ribbon
“Help is needed from both inside and outside the country to
prevent and control diabetes in China. We believe cooperation
between IDF and CDS will improve diabetes prevention and control,
not only in China but also around the world,” said Prof Ji.
According to the IDF Diabetes Atlas, an estimated 285 million
people have diabetes around the world. If nothing is done, this
figure will reach 438 million by 2030.
In May 2010, United Nations member states unanimously voted in
favour of a High Level Meeting of the UN General Assembly on
Non-Communicable Diseases (NCDs) to be held in September 2011 in New
A similar UN summit on HIV/AIDS in 2001 proved to be a turning
point in combating the disease, resulting in the setting up of
global funding and a strong international civil-society movement.
“We are working to ensure the UN Summit on NCDs will take global
action to a new level: raising the profile of too-long neglected
diseases such as diabetes, mobilizing the international community,
securing commitments from Heads of State, and sending a clear
message to international donors on the importance of tackling NCDs,”
IDF is coordinating a programme of work, called the Diabetes
Roadmap, that will produce and package arguments, evidence and
solutions to ensure that the UN Summit translates into real change
for the millions of people with diabetes worldwide.
On World Diabetes Day, IDF is launched A Call to Action on
Diabetes, the first key activity from the Diabetes Roadmap
programme, which will be the central advocacy tool for the global
diabetes community in the lead up to the UN Summit.
“The global diabetes community must now move on from saying we
have a problem to saying we know how to turn this epidemic around.
We know what to do — we have the evidence, we have cost-effective
solutions, we have the tools, we have the skills. And now, we are
slowly seeing global political will for action,” said Mbanya.
“The time to act for diabetes is now.”
About World Diabetes Day
World Diabetes Day is
celebrated on 14 November each year, a date chosen to mark the
birthday of Sir Frederick Banting, one of the pioneers in diabetes
research. It was introduced in 1991 by the International Diabetes
Federation (IDF) and the World Health Organization (WHO) in response
to the alarming rise in diabetes around the world. In 2007, the
United Nations marked the Day for the first time with the passage of
the United Nations World Diabetes Day Resolution in December 2006,
which made the existing World Diabetes Day an official United
Nations World Health Day.
World Diabetes Day is
represented by the blue circle logo—the global symbol of diabetes. wwww.worlddiabetesday.org
Do you have diabetes?
Take the Blue Circle Test. Find out whether you could be at risk
by taking the Blue Circle Test, a special online educational
application developed by the International Diabetes Federation to
showcase the risk factors for type 2 diabetes and the positive
actions that individuals can take to reduce their risk.
The Test allows visitors to learn about the risk factors and
establish a personalised risk profile with information about those
factors that they consider relevant to themselves.