People diagnosed with diabetes may lose up to 9 years of their life on average, according to a new study in China. The study warns that this is mainly due to inadequate treatment, and particularly in rural areas.The prevalence of diabetes in China has quadrupled in recent decades with 100 million adults now affected, researchers said. Since the increase in diabetes is recent, the full eventual effect on mortality is unknown.Researchers from University of Oxford in the UK and Peking University in China examined the association of diabetes with mortality in 500,000 adults aged 30-79. Between 2004 and 2008 study participants were recruited in five rural and five urban areas of China and followed up for cause-specific mortality until 2014. The study found that people with diabetes had twice the risk of dying during the follow-up period compared to other study participants.Diabetes was associated with increased mortality from a wide range of conditions, including heart disease, stroke, kidney disease, liver disease, infection, and cancers of the liver, pancreas and breast. "In recent decades, Chinese adult mortality rates have been falling but this decrease will be slowed or even halted by diabetes, unless there is substantial improvement in treatment," said Zhengming Chen, from Oxford.Diabetes was more common in urban than rural areas of China (8 per cent vs 4 per cent respectively), but the associated health risks were higher in rural than in urban areas.The risk of dying from inadequately treated acute complications of diabetes (diabetic ketoacidosis or coma) was four times as great in rural as in urban areas, and even in urban areas it was much higher than in Western populations. Although three-quarters of those known to have diabetes were being treated, their mean blood glucose levels remained much too high and few were being given cardiovascular-protective medication, such as statins and blood-pressure-lowering treatments.
"Of the many people in China with diabetes, few are adequately managed. This is causing a lot of premature deaths, particularly in rural areas," said Fiona Bragg, first author of the report published in the Journal of the American Medical Association (JAMA). Most previous studies have been in high-income countries where people with diabetes have reasonably good control of blood glucose and statins and blood-pressure-lowering drugs are widely used.
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