Diabetes' new frontier: China

Ye Bin, a 35 year-old salesman in Shanghai, discovered he had diabetes a year ago. He is one of an estimated 114 million people in China who have the disease. A survey published last year revealed that one in every three diabetics globally now lives in China. The country's rapid economic growth has meant drastic changes in diet and exercise for hundreds of millions of Chinese. One diabetes expert calls China's diabetes epidemic a 'catastrophe'.

It was last September when doctors realized how bad China’s diabetes epidemic really was. The most comprehensive survey ever conducted in China, published by the American Medical Association, revealed 114 million Chinese – a population the size of Mexico’s – now has the disease.

Paul Zimmet, honorary president of the International Diabetes Federation, says the sheer number of diabetics in China is catastrophic. It’s forced him to frame the global epidemic in a new way. "We’re now saying that if diabetes was a country, it would be third, actually, after China and India as a country," says Zimmet, "because we’re now seeing something like 380 million people worldwide with diabetes."

1 in every 3 of them now lives in China.

They’re people like Ye Bin, a 35 year-old salesman who meets me for lunch near his Shanghai office. Before the food arrives, he arranges a handful of pills beside his chopsticks – medicine to treat type 2 diabetes. He places the pills in his mouth, one by one. “It’s been a year since I was diagnosed," says Ye Bin between gulps of water. "Now I try not to eat anything with sugar. I used to drink soft drinks all the time. I can’t do that anymore.”

Ye grew up as an only child. He belongs to a generation defined by China’s one-child policy -- a hundred million individuals nicknamed ‘Little Emperors.’ Ye admits his parents –business types who became rich off of China’s growth– spoiled him. They grew up surrounded by famine and violent political campaigns. Like many Chinese parents in the 1980s, they wanted an easier life for their only son.

“When I was young, we ate out three or four times a week," remembers Ye. "At home, my parents always fed me Ferrero Rocher chocolates. We had lots of those at home. They were a sign of wealth back then.”

Another sign you made it was dining out at the increasing number of American fast food restaurants in China.

In one of many McDonald's ads on Chinese television, a girl screams “I’ve got a magic box!” She holds up her Happy Meal and smiles as her friends cheer. The commercial is a reminder of how the diabetes epidemic began in the United States.

But in China, say experts, the conditions seem even more ripe: globalization, urbanization, and - in terms of exercise - stagnation.

"Fewer people ride bicycles in China these days, fewer people walk," says Xu Zhangrong, deputy secretary of the China Diabetes Society. "More people are driving cars. And think of the environmental factors - the air is often smoggy, so fewer people go outside to exercise."

In 1980, less than 1 percent of Chinese adults had diabetes – now it’s at least 10 percent. Zhang says 1 in 4 Chinese have abnormal blood sugar levels – a precursor to the disease. Doctor Xu says the sudden rise of diabetes in China is not only a health threat, but an economic one. He says it could bankrupt the country’s healthcare system.

“It’s a big problem – about 80 percent of the expenditures on diabetes treatment in China goes to treating complications, the most expensive type of treatment," says Zhang. "But because many Chinese can’t afford proper healthcare, they’re forced to wait until they experience complications.”

In the waiting room of a diabetes clinic in Shanghai, it's standing-room only. More than a hundred people take a number and wait for an automated voice to direct them to an available doctor. With plans to move 100 million people to the city in the next five years, Doctor Xu says waiting times in China will only become longer.

But Xu says one thing can’t wait: China needs to shift its focus from treating diabetes to preventing it.

About the author

Rob Schmitz is Marketplace’s China correspondent in Shanghai.

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