Diabetes and Its Chronic Complications in the She Ethnic Minority Group of China

Abstract

Objective: According to recent reports, the development of type 2 diabetes in China has soared at an alarming rate. However, most of the investigations were based on Han people, who account for the majority of people in China. Little is known about the prevalence of diabetes its chronic complications in the She people, who have their own traditional lifestyle and hereditable background, different from other Asian population. The present study investigated the prevalence of type 2 diabetes and associated risk factors in the adult population of She nationals. Subjects and Methods: A total of 5,385 participants entered into the analysis eventually, including 2,308 men and 3,077 women. An oral glucose tolerance test was performed in subjects without diagnosed diabetes. Liver function, cardiovascular risk (brachial-ankle pulse wave velocity, estimated glomerular filtration rate, and abnormal Minnesota codes findings), uric acid, and neuropathy were tested to assess the profiles of associated risks. Results: In general, the self-reported diabetes rate was 9.5%. After age and sex standardization, the prevalence of diabetes was 6.1% (6.7% for men and 5.7% for women) in She Chinese people. In logistic regression models, age, family history of diabetes, alcohol use, total cholesterol, and triglycerides were all significantly associated with the risk of diabetes in this cross-sectional study (all P < 0.05). In all, 47.4% had cardiovascular risks, 19.4% had liver dysfunction, and 6.2% had hyperuricemia. For women, compared with the first quartile, log-transformed homeostasis model assessment for insulin resistance of the fourth quartile was significantly higher (P < 0.05), and log-transformed homeostasis model assessment for b cells was also higher in the second, third, and fourth quartiles (all P < 0.05). The prevalences of polyneuropathy in impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG/IGT, and diabetes mellitus (DM) were 16.1%, 13.1%, 18.6%, and 28.4% separately, which was higher than that in normal glucose tolerance. The prevalences of polyneuropathy in IFG/IGT and DM were higher than that in IGT. Conclusions: The present study revealed that a total of 6.1% She people suffered from type 2 diabetes, which was lower than the average level of China, but the standardized prevalence of prediabetes was higher, 20.6%. Early peripheral neuropathy screening should be performed in the prediabetes population. The Toronto Clinical Neuropathy Scoring System is convenient to assess diabetic polyneuropathy in clinical practice and should be tested regularly for people in prediabetes. Liver dysfunction, headache, and insomnia, appearing before type 2 diabetes, should be assessed regularly to avoid deterioration.

Metabolic syndrome is related to polyneuropathy and impaired peripheral nerve function: a prospective population-based cohort study

“…In contrast with some other studies, we did not find an association of polyneuropathy with IFG. Most studies that suggested an association between pre-diabetes and polyneuropathy lacked a control group,4–8 or did not control for age, which is strongly related to both polyneuropathy and (pre)diabetes 10 34 35. One controlled study did show an association of IGT and neuropathy,9 while the majority of controlled studies, especially the studies that took the confounding effect of age into account, found no association 11–13 15 25 30 31 36.…”

High Energy Diets-Induced Metabolic and Prediabetic Painful Polyneuropathy in Rats

“…However, an age- and sex-matched, population-based MONICA (Monitoring Trends and Determinants on Cardiovascular Diseases)/KORA (Cooperative Research in the Region of Augsburg) study of subjects aged 25–74 years showed prevalence of polyneuropathy in 7.4% of those with normal glucose tolerance, 11.3% of those with IFG, 13.0% of those with IGT, and 28.0% of the diabetic subjects [25]. More recently, another age- and sex-standardized epidemiological study in the She Ethnic Minority Chinese subjects aged ≥20 to ≤80 years old revealed prevalence of polyneuropathy in 16.1% of those had IFG, 13.1% had IGT, 18.6% had both IFG and IGT, and 28.4% had diabetes [11]. Others have questioned the link between prediabetes and polyneuropathy.…”

“…In China, along with 9.7% diabetes prevalence, the number of prediabetic people has been estimated at 148.2 million adults, accounting for 15.5% of the population [10]. Furthermore, the prevalence of both prediabetes and diabetes is age-dependent with the peak of prediabetes (50–60 years old) being ten years earlier than that for diabetes (60–70 years old) [10], [11], supporting the existence of pre-clinical processes in T2DM patients.…”

Determination of Peripheral Neuropathy Prevalence and Associated Factors in Chinese Subjects with Diabetes and Pre-Diabetes – ShangHai Diabetic neuRopathy Epidemiology and Molecular Genetics Study (SH-DREAMS)

“…In China, a study on the She ethnic minority group revealed the prevalence of polyneuropathy in impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG/IGT, and diabetes mellitus (DM) to be 16.1%, 13.1%, 18.6%, and 28.4% respectively, which are greater than that in patients with normal glucose tolerance (NGT) [3]. A study on a Western population revealed that the prevalence of neuropathic pain was 13.3%, 8.7%, 4.2%, and 1.2% in normal subjects and subjects with diabetes, IGT, and IFG, respectively [4].…”