Objectives: To examine the epidemic of diabetes and its impact on cardiovascular disease (CVD) in China.

Methods: We searched PubMed and local databases for studies published since 1980. Information on study design, sample characteristics, diagnosis, and prevalence of diabetes were extracted using a standardized protocol. We calculated average annual increases in rates and the population attributable risk of CVD due to Type 2 diabetes (T2D).

Results: Nationwide survey data indicate that the prevalence of T2D in Mainland China has increased from 0.67% in the early 1980s to 3.21% in the mid-1990s and to 5.5% in 2001–02. A 2001–02 national survey among people aged 35–74 showed that the prevalence was 5.2% in men and 5.8% in women. The prevalence increases with age and is higher in urban- than rural areas. The annual increase in the rate of T2D and impaired glucose tolerance were 0.70% and 0.64% point, respectively. People in Hong Kong and Taiwan (approximately 8–10%) had a higher prevalence of T2D than on the Mainland. Chinese adults with diabetes were 1.7 times more likely to develop CVD than those with normal fasting glucose. We estimated that 3.3% of CVD in China is attributable to T2D.

Conclusions: The prevalence of T2D has steadily increased in China over the past two decades, although it remains lower than many industrialized countries. Considerable differences in prevalence exist across regions and population groups. Urban and higher-income groups are affected the most, in particular, due to changes in lifestyle and a rising obesity epidemic. Timely national strategies are needed for the prevention, screening, and treatment of T2D.