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Establishing the evidence base: diabetes research in China

China has now overtaken India as the country with the most people living with diabetes. According to the International Diabetes Federation, the disease affects one in 10 adults in China, and costs around US$26 billion a year in treating the condition.

For developing countries, the concern is the large number of people who remain undiagnosed. In China an estimated 60.7% of people are undiagnosed, likely due to a lack of resources and education. However, the longer someone is undiagnosed, the greater the challenge in treating them, increasing the pressure on families and health systems. Less prevalent is type 1 diabetes, yet in China, little is known about the condition that is fatal unless treated with daily injections of insulin, mainly in young children.

To better understand how the condition is affecting Chinese communities, The George Institute China has established a new diabetes research program. Chief Scientist, Professor JI Linong and Associate Research Professor, Zhang Puhong were appointed in May 2011 and have since assembled a team that is focused on two large-scale projects.

Thanks to support from the International Diabetes Federation and Chinese Diabetes Society, the team are conducting a comprehensive survey of patients living with type 1 diabetes. Nineteen tertiary, secondary and primary hospitals across two cities, Beijing and Shantou, are collating data on the coverage, cost and care of type 1 diabetes. Government officials, over one hundred medical staff, and nearly seven hundred patients have already been interviewed. Based on results of this large pilot, the team aims to secure further funding to increase the scale of the program.

Secondly, a large-scale Observational Registry for Basal Insulin Treatment (ORBIT) study was launched in November 2011. This study will investigate the real world use of basal insulin, to clearly identify the clinical effect of the treatment, and how it may improve management of diabetes in adults.

“Around 200 hospitals from different parts of China will take part in this study, and 20,000 patients with type 2 diabetes will be enrolled over the next twelve months”, said Professor JI. “We will compare a number of available treatments, to assess the effectiveness of each one and identify the factor associated with efficacy”, he added. The study participants will be followed for six months.