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Cited by 1,997Diabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, DietDiabetes Treatment and Management

Diabetes in Asia: Epidemiology, Risk Factors, and Pathophysiology

Chan, Juliana C. N., Malik, Vasanti, Jia, Weiping, Kadowaki, Takashi, Yajnik, Chittaranjan S., Yoon, Kun-Ho, Hu, Frank B.·2009·JAMA
DOI 10.1001/jama.2009.726
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Abstract

CONTEXT: With increasing globalization and East-West exchanges, the increasing epidemic of type 2 diabetes in Asia has far-reaching public health and socioeconomic implications. OBJECTIVE: To review recent data in epidemiologic trends, risk factors, and complications of type 2 diabetes in Asia. EVIDENCE ACQUISITION: Search of MEDLINE using the term diabetes and other relevant keywords to identify meta-analyses, systematic reviews, large surveys, and cohort studies. Separate searches were performed for specific Asian countries. The review was limited to English-language articles published between January 1980 and March 2009; publications on type 1 diabetes were excluded. EVIDENCE SYNTHESIS: The prevalence of diabetes in Asian populations has increased rapidly in recent decades. In 2007, more than 110 million individuals in Asia were living with diabetes, with a disproportionate burden among the young and middle aged. Similarly, rates of overweight and obesity are increasing sharply, driven by economic development, nutrition transition, and increasingly sedentary lifestyles. The "metabolically obese" phenotype (ie, normal body weight with increased abdominal adiposity) is common in Asian populations. The increased risk of gestational diabetes, combined with exposure to poor nutrition in utero and overnutrition in later life in some populations, may contribute to the increasing diabetes epidemic through "diabetes begetting diabetes" in Asia. While young age of onset and long disease duration place Asian patients with diabetes at high risk for cardiorenal complications, cancer is emerging as an important cause of morbidity and mortality. CONCLUSIONS: Type 2 diabetes is an increasing epidemic in Asia, characterized by rapid rates of increase over short periods and onset at a relatively young age and low body mass index. Prevention and control of diabetes should be a top public health priority in Asian populations.

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Crossref · 10.1001/jama.2009.726

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  • Diabetes and heart disease incidence has greatly increased in India and China in the past 10 years, an epidemiological transition implying at best a change in penetrance of genetic effects due to the contemporary environment.

    “diabetes and heart disease have greatly increased in incidence in India and China in the past 10 years60,61, an epidemiological transition that at best implies a change in penetrance of genetic effects attributable to any class of variant, rare or common, in the contemporary environment.”

    From Rare and common variants: twenty arguments (2012) · cites this paper as [61]

  • Asian populations tend to develop diabetes at younger ages and lower BMI levels than Caucasians.

    “Asian populations tend to develop diabetes at younger ages and lower BMI levels than Caucasians.”

    From Globalization of Diabetes (2011) · cites this paper as [3]

  • Compared with Western populations, Asians develop diabetes at younger ages, at lower degrees of obesity, and at much higher rates given the same amount of weight gain.

    “Compared with Western populations, Asians develop diabetes at younger ages, at lower degrees of obesity, and at much higher rates given the same amount of weight gain (3).”

    From Globalization of Diabetes (2011) · cites this paper as [3]

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Authors
Chan, J. C. N., Malik, V., Jia, W., Kadowaki, T., Yajnik, C. S., Yoon, K.-H., & Hu, F. B.
Affiliations
Chinese University of Hong Kong (HK)
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2009-05-27
Volume
301
Issue
20
Pages
2129
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2009.726
OpenAlex
W2056526409
Semantic Scholar
332bd476cd38b33f0fbefb7b6ced27239c834816
Cited by
1,997
References
186
Citations by year
2026: 55 · 2025: 76 · 2024: 90 · 2023: 77 · 2022: 93 · 2021: 137 · 2020: 118 · 2019: 114 · 2018: 121 · 2017: 130 · 2016: 132 · 2015: 154 · 2014: 149 · 2013: 181 · 2012: 135
FWCI
89.06
Type
journal article
Language
en
Open access
closed
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
type 2 diabetes, diabetes epidemiology, Asia, diabetes prevalence, obesity, overweight, abdominal fat, nutrition transition, gestational diabetes mellitus, cardiorenal complications, cancer risk, disease duration, diabetes prevention
MeSH terms
Asia, Diabetes Mellitus, Type 2, Humans, Risk Factors, Comorbidity

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