China is on the verge of an epidemic. Bird and swine flu may make the headlines, but the long-term health threat spreading through the country’s population is a silent killer: diabetes.
A study in Journal of the American Medical Association in 2013 suggests that there are 114 million adults in China living with the condition, representing 12 percent of the population. This rate is higher than in America, the nation most often associated with the high-fat diet and sedentary lifestyles linked to diabetes.
Changes in China’s demographics may be exacerbating the problem, but there is also a clear role for poor lifestyle choices, according to internal medicine specialist at Beijing United Family Hospital (BJU), Dr. Xin Yue.
“People are living longer so there are more old people, and then there is also lifestyle,” she says. “More people, especially those living in cities, spend a lot of time at their desks.”
Dr. Yue has also seen changes in how patients become aware of their diabetes. “People used to come in complaining of the symptoms of diabetes,” she explains. “But now more come [earlier]because we can see their blood sugar levels in the results of a health check.”
Although early detection can help manage the condition, diabetes is incurable and, once developed, can lead to a number of serious complications, including heart disease, kidney damage, forced amputations, and more. Type 2 diabetes occurs when the pancreas is unable to produce enough insulin to convert glucose into energy (or the insulin it produces is ineffective), and there are strong causal links between diabetes and the unholy trinity of poor diet, smoking, and lack of exercise.
It is not only adults with a lifetime of bad choices behind them who are at risk. Dr. Yue has seen obese children as young as 12 with the early signs of type 2 diabetes.
Most common among children however, is type 1, where the body is unable to produce insulin at all. Believed to be more closely linked to genetic factors, the symptoms are often acute and can be terrifying for parents, as Ukrainian mom Helen Aris found out at the beginning of February 2012. She became concerned when her usually active son Lucas, now 6 years old, started becoming weak and sleepy.
“He started to drink water all the time and slept a lot during the daytime,” she recalls. “He just came back from his kindergarten and went [straight]to bed. Because he was drinking so much water he [also]went to the bathroom a lot, several times per night. Then he started coughing and complaining that his chest hurt.”
After taking Lucas to hospital, doctors initially told Aris that he had pneumonia. He was given medication and sent home. But after falling into a deep sleep and waking up “panting and mumbling,” she rushed him back, though he fell unconscious in the car.
“They told me later that he had type 1 diabetes. The doctor injected him with a huge amount of glucose and he went into coma. We didn’t [think it could have been]diabetes as no one in my or my husband’s family has it and we even didn’t know its symptoms. [Lucas] was in a pediatric ward for three days and then they transferred us to the diabetes department. His sugars were above 40; normally an adult’s sugars are four or five. He was in coma for three days and these were the scariest days of my life.”
Managing Diabetes in Beijing
Because the family was uninsured, Aris now spends around RMB 1,000 a month on lancets, needles, and test strips. This figure does not include the cost of visits to the doctor and insulin, which in Beijing can only be acquired every two months through a hospital appointment.
Given the extent of the disease in China, patients should face little difficulty getting access to the medicine and equipment they need. If you have insurance or the money to pay, then the quality of care and symptom management should be largely the same as in Western countries, where diabetes has been traditionally more prevalent.
There are specific challenges that face diabetics living in Beijing, however. Healthy and low-sugar meals can be found in the capital’s restaurants but lack of information about the food being served can make it difficult to manage blood sugar levels. BJU’s Dr. Yue always recommends that patients cook at home rather than eat out regularly.
For children, another major problem is that schools are often unprepared for the demands of the disease’s day-to-day management. Insulin-dependent diabetics need a shot before every meal, which can pose difficulties at lunchtime if the school is unfamiliar with the condition. Some nurses, even in international departments, are reportedly unwilling to administer the shots themselves.
This has been one of the ongoing challenges for Aris, who still worries about Lucas’ future.
“I just [have to hope for the]best and do everything to make my son healthy and happy,” she says. “Believing is the only thing I have left.”
Her faith may not be misplaced. Promising medical advances may provide new hope to a generation of young diabetes patients. Stem cell treatments that re-grow the beta cells that create insulin in our bodies are already available in Beijing.
These developments may even help scientists move beyond disease management and towards a cure, according to Dr. Li Chi of Puhua International Hospital, one of the few facilities in Beijing offering the stem cell therapies.
“While our current level of technology allows us to alleviate many of the symptoms and delay the negative impact of this disease, the potential of this area of medicine gives us hope that in the future diabetes could become a curable disease,” she says.
Puhua claims that 70 percent of patients who underwent the stem cell therapies have achieved more stable blood glucose levels, a reduced need for medication, or alleviation of secondary symptoms.
Although the application of stem cell treatments in diabetes, as in other areas of medicine, remains in its earliest stages, there may be a more hopeful future for youngsters like Lucas.
Beijing United Family Hospital (BJU) 北京和睦家医院
Dr. Yue Xin is a diabetes specialist and published researcher who consults in Chinese and English at BJU. She operates from the hospital’s Diabetes Center which offers services ranging from routine examinations to the management of chronic diabetic complications. The center’s team of physicians is supported by a team of nurses, dietitians, and other diabetes specialists.
Tue-Wed 9am-4pm (endocrinology clinic). Bldg 2, 2 Jiangtai Lu, Chaoyang District (5927 7059 or 400 8919 191) www.beijing.ufh.com.cn 朝阳区将台路2号2号楼
Puhua International Hospital, Shuangjing 普华国际门诊
Dr. Li Chi has been working to apply stem cell technology in the treatment of diabetes for nearly a decade. She works at Puhua’s Diabetes Center, one of the few places in Beijing offering the treatments.
Daily 9am-6pm. 54 Wusheng Beilu, Dongsanhuan, Chaoyang District (5363 1264 for diabetes care; 8773 5522 for general inquiries) www.puhuaclinic.com 朝阳区东三环武圣北路54号
Diabetes Changing the World (www.diabetesnchina.mixxt.org)
An online support group for people with diabetes. Beijing meet-ups are arranged at BJU. To find out about upcoming events or to get in touch with other diabetics in Beijing, visit the website or contact Dr. Gerald Anthony by email at firstname.lastname@example.org.
photo by SUI
This article originally appeared on p24-25 of the beijingkids January 2014 issue.
Check out the PDF version online at Issuu.com