Diabetes prevention programme

Objectives

Predictions of a further increase in the number of people with diabetes in China emphasise the importance of preventive efforts towards the onset of diabetes and the provision of appropriate treatment for people already living with diabetes.

With the prevalence of diabetes in Qingdao at 7.5%, it is essential to have a basis for early diagnosis and proper management of diabetes.

It is, however, equally important to raise public awareness of diabetes and its risk factors - which is presently very poor in Qingdao: 20% in urban and 10% in rural areas. This would contribute to limiting the number of people with the disease in the future.

For this purpose, primary prevention has been considered the most cost-effective approach to combat the impact of diabetes on the general population.

An ongoing WDF-supported project in China, "National diabetes programme" (WDF02-036), already pays attention to people living with diabetes by focusing on treatment and capacity building within the health care system nationwide.

The present project has a significant component of primary prevention and awareness raising in the general public, thereby supplementing WDF02-036. It is hoped that the model developed in Qingdao may be used in other regions of China for primary prevention of diabetes.

The project aims to implement a diabetes prevention programme targeting the population of Qingdao to promote public awareness and improve diabetes care.

Approach

The prevention programme will be implemented through three concurrent strategies aimed at:
1. The general public
2. People at high risk for developing diabetes
3. People with undiagnosed diabetes.

These accompanying strategies ensure that the interventions have an impact at various levels in the society of Qingdao.

The first strategy - the population strategy - is aimed at raising public awareness of diabetes and promoting health in the entire population. This is done using education and interventions to promote a healthy diet and physical activity. The methods used are advocacy, school interventions, media communication, training of health care professionals and lifestyle consultations.

The second high-risk strategy - is aimed at preventing or delaying the onset of diabetes by identifying and managing people at high risk for developing diabetes. Concrete activities in this strategy are screening for conditions associated with the development of diabetes and interventions to modify or control the identified risk conditions.

The third strategy - the strategy of early diagnosis and management - is aimed at improving patient care by providing systematic treatment and preventing the development of complications. This strategy includes establishing a systematic registration and referral system and educating doctors to become diabetes specialists. The three strategies target different levels of society, and by combining them is, the intention to create a basis for preventing new diabetes cases and for proper management of people already living with diabetes.

Results at completion

• A simplified diabetes risk score developed
• 1.2 million people underwent risk assessment, and 444,548 were identified as high-risk
• 1.94 million people exposed to diabetes awareness campaigns through media
• 901 school nurses and 1463 health care professionals trained and working for the project
A network built between the project organisers, primary care units and other relevant organisations