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Diabetes in China: epidemiology, pathophysiology and multi-omics

Nature Metabolism volume 7, pages 16–34 (2025)Cite this article

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Abstract

Although diabetes is now a global epidemic, China has the highest number of affected people, presenting profound public health and socioeconomic challenges. In China, rapid ecological and lifestyle shifts have dramatically altered diabetes epidemiology and risk factors. In this Review, we summarize the epidemiological trends and the impact of traditional and emerging risk factors on Chinese diabetes prevalence. We also explore recent genetic, metagenomic and metabolomic studies of diabetes in Chinese, highlighting their role in pathogenesis and clinical management. Although heterogeneity across these multidimensional areas poses major analytic challenges in classifying patterns or features, they have also provided an opportunity to increase the accuracy and specificity of diagnosis for personalized treatment and prevention. National strategies and ongoing research are essential for improving diabetes detection, prevention and control, and for personalizing care to alleviate societal impacts and maintain quality of life.

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Fig. 1: Trend of number of adults with diabetes across IDF regions during the last two decades.
Fig. 2: Different risk-conferring and protective factors for T2D in Chinese women and men.
Fig. 3: Genomics of T2D.
Fig. 4: Metagenomic and metabolomic discoveries and therapeutic targets in T2D in China.

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Acknowledgements

This work was supported by the National Key Research and Development Program of China (2022YFA1004804), Shanghai Municipal Key Clinical Specialty and Shanghai Research Center for Endocrine and Metabolic Diseases (2022ZZ01002), Shanghai Key Discipline of Public Health Grants Award (GWVI-11.1-20) and the Sanming Project of Medicine in Shenzhen (SZSM202311019). We acknowledge the support of the Hong Kong Genome Institute for the genetic/genomic research of diabetes and its complications in the Hong Kong Chinese population.

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Authors and Affiliations

  1. Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Weiping Jia

  2. Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China

    Weiping Jia

  3. Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences and Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China

    Juliana CN Chan

  4. Tsinghua Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China

    Tien Y. Wong

  5. Singapore National Eye Center, SingHealth, Singapore, Singapore

    Tien Y. Wong

  6. Peers for Progress, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Edwin B. Fisher

Authors
  1. Weiping Jia
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  2. Juliana CN Chan
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  3. Tien Y. Wong
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  4. Edwin B. Fisher
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Contributions

W.J., J.C.C., T.Y.W. and E.B.F. researched data for the article and wrote, reviewed and edited the manuscript.

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Correspondence to Weiping Jia.

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Nature Metabolism thanks the anonymous reviewers for their contribution to the peer review of this work. Primary Handling Editor: Yanina-Yasmin Pesch, in collaboration with the Nature Metabolism team.

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Jia, W., Chan, J.C., Wong, T.Y. et al. Diabetes in China: epidemiology, pathophysiology and multi-omics. Nat Metab 7, 16–34 (2025). https://doi.org/10.1038/s42255-024-01190-w

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