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Prevalence and Identification of Type 1 Diabetes in Chinese Adults with Newly-Diagnosed Diabetes

35 Pages Posted: 25 Oct 2018

See all articles by Xia Li

Xia Li

Central South University - Department of Endocrinology and Metabolism

Xiaohan Tang

Central South University

Xiang Yan

Central South University

Houde Zhou

Central South University

Gan Huang

Central South University

Shuoming Luo

Central South University

Xilin Yang

Tianjin Medical University

Xiaohong Niu

Changzhi Medical College

Jing Liu

Gansu Provincial Hospital

Caifeng Yan

Yangzhou University - Northern Jiangsu People's Hospital; Yangzhou University - Northern Jiangsu People's Hospital

Huibiao Quan

Hainan Medical University - Department of Endocrinology

Chao Zheng

Wenzhou Medical University

Liyong Yang

Fujian Medical University - Union Hospital

Gebo Wen

University of South China

Tao Yang

Nanjing Medical University - Nanjing Medical Hospital

Hongwei Jiang

Henan University of Science and Technology

Meibiao Zhang

The First People’s Hospital of Huaihua

Jianping Wang

University of South China

Heng Su

Kunming University of Science and Technology - First People's Hospital of Yunnan Province

Zhiming Deng

The First People’s Hospital of Changde City

Qiuxia Huang

Government of the People's Republic of China - Dongguan Third People’s Hospital

Yi Zhang

Fujian Medical University - Union Hospital

Hui Sun

Inner Mongolia Medical University

Zhaohui Mo

Central South University

Qifu Li

Chongqing Medical University - Department of Endocrinology

Changqing Luo

The First People’s Hospital of YueYang

Lixin Guo

Beijing Hospital - National Center of Gerontology, Department of Endocrinology

Yuling He

Guangxi Medical University

Jian Kuang

Guangdong Academy of Medical Sciences - Guangdong General Hospital

Hui Fang

Tangshan Gongren Hospital

Ling He

South China University of Technology - Guangzhou First People’s Hospital

Yu Liu

Nanjing Medical University - Nanjing Medical Hospital

Zhongyan Shan

China Medical University - Department of Endocrinology and Metabolism; China Medical University - Institute of Endocrinology

Qiuhe Ji

Government of the People's Republic of China - Fourth Military Medical University

Linong Ji

Peking University - Department of Endocrinology and Metabolism

Zhiguang Zhou

Central South University - Key Laboratory of Diabetes Immunology

National Clinical Research Center for Metabolic Diseases Study Group

Independent

More...

Abstract

Background: The incidence of type 1 diabetes mellitus (T1DM), especially in children, has rapidly increased in China. However, the prevalence of adult-onset classic T1DM and latent autoimmune diabetes of adults (LADA) remains unknown.      

Methods: A nationwide, multicenter survey of newly-diagnosed diabetes in adults aged ≥30 years was conducted from hospitals in 24 Chinese provincial administrative areas from April 2015 to October 2017. Classic T1DM, identified based on insulin-dependency, and standardized glutamic acid decarboxylase autoantibody testing, was used to differentiate LADA from patients with initially an undefined diabetes type. The age and sex distributions from a large national survey of diabetes in China conducted in 2010, were used to standardize the prevalence of T1DM and LADA.

Findings: Among 17,349 adult patients, the prevalence of T1DM was 5·84% (5·14% in males and 6·16% in females), with 65% of these having LADA. The prevalence of classic T1DM decreased with increasing age (p<0·05), while that of LADA was stable (p>0·05). The prevalence of T1DM in overweight or obese patients was 3·4% and 2·4%, respectively, and LADA accounted for 75% and 80% of T1DM in these two groups. LADA's cumulative age distribution was much closer to type 2 diabetes mellitus (T2DM) than to that of classic T1DM.    

Interpretation: T1DM, especially LADA, was prevalent in newly-diagnosed adult-onset diabetes in China, which highlights the importance of identification of LADA in clinical practice in China.    

Funding Statement: The National Science and Technology Infrastructure Program and the National Key R&D Program of China.    

Declaration of Interests: The authors declare that they have no competing interests.

Ethics Approval Statement: The ethics review committee/institutional review board of each of the participating hospitals approved the study protocol. Written informed consent was obtained from all the participants before data collection.

Keywords: Type 1 Diabetes Mellitus; Latent Autoimmune Diabetes in Adults; Type 2 Diabetes; Newly-Diagnosed Diabetes; Prevalence

Suggested Citation

Li, Xia and Tang, Xiaohan and Yan, Xiang and Zhou, Houde and Huang, Gan and Luo, Shuoming and Yang, Xilin and Niu, Xiaohong and Liu, Jing and Yan, Caifeng and Quan, Huibiao and Zheng, Chao and Yang, Liyong and Wen, Gebo and Yang, Tao and Jiang, Hongwei and Zhang, Meibiao and Wang, Jianping and Su, Heng and Deng, Zhiming and Huang, Qiuxia and Zhang, Yi and Sun, Hui and Mo, Zhaohui and Li, Qifu and Luo, Changqing and Guo, Lixin and He, Yuling and Kuang, Jian and Fang, Hui and He, Ling and Liu, Yu and Shan, Zhongyan and Ji, Qiuhe and Ji, Linong and Zhou, Zhiguang and Group, National Clinical Research Center for Metabolic Diseases Study, Prevalence and Identification of Type 1 Diabetes in Chinese Adults with Newly-Diagnosed Diabetes (October 18, 2018). Available at SSRN: https://ssrn.com/abstract=3269603 or http://dx.doi.org/10.2139/ssrn.3269603

Xia Li

Central South University - Department of Endocrinology and Metabolism

Changsha, Hunan 410011
China

Xiaohan Tang

Central South University

Changsha, Hunan 410083
China

Xiang Yan

Central South University

Changsha, Hunan 410083
China

Houde Zhou

Central South University

Changsha, Hunan 410083
China

Gan Huang

Central South University

Changsha, Hunan 410083
China

Shuoming Luo

Central South University

Changsha, Hunan 410083
China

Xilin Yang

Tianjin Medical University

Tianjin, 300060
China

Xiaohong Niu

Changzhi Medical College

Changzhi
China

Jing Liu

Gansu Provincial Hospital

Lanzhou
China

Caifeng Yan

Yangzhou University - Northern Jiangsu People's Hospital

China

Yangzhou University - Northern Jiangsu People's Hospital

China

Huibiao Quan

Hainan Medical University - Department of Endocrinology

Haikou, Hainan 570311
China

Chao Zheng

Wenzhou Medical University

Zhejiang Province
China

Liyong Yang

Fujian Medical University - Union Hospital

Fuzhou, Fujian 350001
China

Gebo Wen

University of South China

Hunan Sheng, Hengyang Shi
Zhengxiang Qu
China

Tao Yang

Nanjing Medical University - Nanjing Medical Hospital

Nanjing
China

Hongwei Jiang

Henan University of Science and Technology

263 Kaiyuan Ave, Luolong Qu
Luoyang Shi, Henan Sheng
China

Meibiao Zhang

The First People’s Hospital of Huaihua

Huaihua
China

Jianping Wang

University of South China

Hunan Sheng, Hengyang Shi
Zhengxiang Qu
China

Heng Su

Kunming University of Science and Technology - First People's Hospital of Yunnan Province

Kunming
China

Zhiming Deng

The First People’s Hospital of Changde City

Changde
China

Qiuxia Huang

Government of the People's Republic of China - Dongguan Third People’s Hospital

Dongguan
China

Yi Zhang

Fujian Medical University - Union Hospital

Fuzhou, Fujian 350001
China

Hui Sun

Inner Mongolia Medical University

Hohhot
China

Zhaohui Mo

Central South University

Changsha, Hunan 410083
China

Qifu Li

Chongqing Medical University - Department of Endocrinology ( email )

China

Changqing Luo

The First People’s Hospital of YueYang

Yueyang
China

Lixin Guo

Beijing Hospital - National Center of Gerontology, Department of Endocrinology

China

Yuling He

Guangxi Medical University

22 Shuangyong Rd
Qingxiu Qu, Nanning Shi
Guangxi Zhuangzuzizhiqu, 530021
China

Jian Kuang

Guangdong Academy of Medical Sciences - Guangdong General Hospital

Daxuecheng Outer Ring E Rd,
Panyu Qu
Guangzhou Shi, Guangdong Sheng
China

Hui Fang

Tangshan Gongren Hospital

China

Ling He

South China University of Technology - Guangzhou First People’s Hospital

Guangzhou, GD 510180
China

Yu Liu

Nanjing Medical University - Nanjing Medical Hospital

Nanjing
China

Zhongyan Shan

China Medical University - Department of Endocrinology and Metabolism ( email )

No 155, Nanjing Bei Street
Shenyang, Liaoning 110001
China

China Medical University - Institute of Endocrinology

Shenyang, Liaoning 110001
China

Qiuhe Ji

Government of the People's Republic of China - Fourth Military Medical University

Xi'an, Shaanxi 710038
China

Linong Ji

Peking University - Department of Endocrinology and Metabolism ( email )

Beijing
China

Zhiguang Zhou (Contact Author)

Central South University - Key Laboratory of Diabetes Immunology ( email )