Diabetes in China: a societal solution for a personal challenge
Diabetes in China: a societal solution for a personal challenge
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DOI：
10.1016/s2213-8587(14)70144-5
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发表时间：
2014-12-01
影响因子：
44.5
通讯作者：
Ning, Guang
中科院分区：
文献类型：
--
作者：
Chan, Juliana C. N.;Zhang, Yuying;Ning, Guang
中国有很大的糖尿病负担：2013年，全球四分之一的糖尿病患者在中国，其中11.6%的成年人患有糖尿病，50.1%患有前驱糖尿病。许多人未被诊断，未经治疗或不受控制。这种流行病是快速社会转型的结果，在传统生活方式和饥荒时期的背景下导致了肥胖环境，这使得中国人处于糖尿病和多种疾病的高风险之中。社会决定因素，包括社会差距和心理社会压力与因素相互作用，如低度感染，环境污染，照顾碎片化，健康文盲，次优的自我照顾，以及社区支持不足，引起不同的亚表型和后果，特别是肾功能障碍和癌症。在《中国非传染性疾病防治规划（2012- 2015年）》中，中国政府提出通过公共措施、多部门合作和社会动员，创造有利于健康的环境，并对卫生保健系统进行改革。在等待这些长期战略的结果的同时，我们主张使用有针对性的积极主动的方法来识别糖尿病高危人群进行预防，并建立公私社区伙伴关系，使综合护理更容易获得和可持续，重点是登记，授权和社区支持。糖尿病对社会和个人的挑战具有多方面的性质，需要采取多方面的预防解决方案，以减少日益增加的疾病负担。
China has a large burden of diabetes: in 2013, one in four people with diabetes worldwide were in China, where 11.6% of adults had diabetes and 50.1% had prediabetes. Many were undiagnosed, untreated, or uncontrolled. This epidemic is the result of rapid societal transition that has led to an obesogenic environment against a backdrop of traditional lifestyle and periods of famine, which together puts Chinese people at high risk of diabetes and multiple morbidities. Societal determinants including social disparity and psychosocial stress interact with factors such as low-grade infection, environmental pollution, care fragmentation, health illiteracy, suboptimal self-care, and insufficient community support to give rise to diverse subphenotypes and consequences, notably renal dysfunction and cancer. In the China National Plan for Non-Communicable Disease Prevention and Treatment (2012-15), the Chinese Government proposed use of public measures, multisectoral collaborations, and social mobilisation to create a health-enabling environment and to reform the health-care system. While awaiting results from these long-term strategies, we advocate the use of a targeted and proactive approach to identify people at high risk of diabetes for prevention, and of private-public-community partnerships that make integrated care more accessible and sustainable, focusing on registry, empowerment, and community support. The multifaceted nature of the societal and personal challenge of diabetes requires a multidimensional solution for prevention in order to reduce the growing disease burden.