title: Causes of type 2 diabetes in China.
abstract: The prevalence of diabetes in China has increased substantially over recent decades, with more than 100 million people estimated to be affected by the disease presently. During this period there has been an increase in the rates of obesity and a reduction in physical activity. Many of the changes in lifestyle and diet are a result of increased economic development and urbanisation. In addition to an increasingly westernised diet, the traditional Chinese diet also plays a part, with the quantity and quality of rice intake linked to the risk of type 2 diabetes. Familial factors including inherited genetic variants are important, although differences in the genetic architecture suggest a different combination of genetic variants could be most relevant in Chinese when compared with Europeans. Recent advances have also emphasised the role of early life factors in the epidemic of diabetes and non-communicable diseases: maternal undernutrition, maternal obesity, and gestational diabetes are all linked to increased risk of diabetes in offspring. A mismatch between developmentally programmed biology and the modern environment is relevant for countries like China where there has been rapid economic transformation. Multisectoral efforts to address the risks will be needed at different stages throughout the lifecourse to reduce the burden of diabetes.
authors.affiliation: Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, and The Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; International Diabetes Federation Centre of Education, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China. Electronic address: rcwma@cuhk.edu.hk.
authors.forename: Ronald Ching Wan
authors.initials: RC
authors.lastname: Ma
authors.affiliation: Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and Graduate University of the Chinese Academy of Sciences, Shanghai, China. Electronic address: xlin@sibs.ac.cn.
authors.forename: Xu
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. Electronic address: wpjia@sjtu.edu.cn.
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
mesh_terms: D044466:Asian People; D002681:China / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology* / Q000235:genetics / Q000517:prevention & control; D004032:Diet; D004198:Disease Susceptibility; D058872:Epidemics / Q000145:classification; D006801:Humans; D008019:Life Style; D009043:Motor Activity; D009765:Obesity; D012307:Risk Factors; D014507:Urbanization