中国糖尿病的流行病学现状及展望

Epidemiology and research advances in diabetes mellitus in China

摘要:

糖尿病作为一种慢性多发疾病逐渐成为全球关注的重点公共卫生问题，而中国糖尿病患病人数已跃居世界第一。糖尿病的患病率呈现逐年递增趋势，是以遗传因素为基础，不良生活方式为推动剂，社会经济状况改变和人口老龄化为背景的多种因素相互作用的结果。此外，糖尿病患病率递增的趋势也受到诊断标准界定值调整的影响。我国一直采用世界卫生组织1999年制定的糖尿病诊断标准，而糖化血红蛋白能否成为新的诊断标准国内各研究机构及学者尚未达成一致意见。糖尿病及其相关并发疾病将严重影响患者生存质量和预期寿命，给患者、社会卫生保健体系带来了巨大的医疗和经济负担，早期诊断和防治至关重要。然而，目前对糖尿病的管理却呈现低知晓率、低治疗率、低达标率和高患病率的“三低一高”状态，给本病防治带来了巨大挑战。提高糖尿病的诊治水平，早预防、早治疗、早达标则成为了患者个人、公共卫生领域及医疗机构以及政府和社会共同努力、积极探索的方向。

Abstract:

Diabetes mellitus，as a common chronic disease，has become a public health problem worldwide. The prevalence of diabetes in China has become the highest all over the world. Such rapidly increasing prevalence year after year was caused by genetic factors，improvement of socioeconomic status，aging of population，and most importantly，the change of life style. In addition，the revision of diagnosis criteria of diabetes also influences its prevalence. In China，the diagnosis of diabetes has been made according to 1990 WHO diagnostic criteria of diabetes for a long time. Whether glycosylated hemoglobin（HbAlc） should be included in the new criteria is still under discussion. Diabetes as well as its complications greatly compromises the patients’ quality and expectation of life，and brings heavy burden to both the patients and social health care system. Therefore the early diagnosis and treatment of di－abetes are crucial. However，the low awareness rate，treatment rate and target rate，along with the high prevalence of diabetes reflect that the management of diabetes is in urgent need of improvement. The cooperation of patients，government，public health and medical institution is warrant to better solve this public health problem with its early diagnosis，treatment and control.