What Kind of Diabetes Management Do Patients Really Need? Reflections from a Senior Endocrinologist at a Top-Tier Hospital

With China’s rapid economic surge, residents’ nutritional status has improved significantly and lifestyles have undergone profound changes. Yet chronic diseases such as obesity and diabetes are surging like a tide, with onset ages continuing to decline, posing a health concern that cannot be ignored. Against the backdrop of the “Healthy China 2030” Planning Outline, which clearly sets forth national health goals, innovation and exploration in the medical field have never ceased.

Taking diabetes, a major chronic disease that has become a significant threat to global public health, as an example, the 11th edition of the IDF Diabetes Atlas published by the International Diabetes Federation (IDF) shows that among the 589 million adults with diabetes worldwide, China accounts for 148 million patients, representing 18% of the global total and ranking second in the world, indicating a severe management situation.

Amid this high-pressure landscape, China’s healthcare sector, guided by strategic policy directives, has pioneered innovative diabetes management solutions that inject new momentum into domestic prevention and control efforts while offering high-value insights for global diabetes governance.

From May 21 to 24, at the 5th BEYOND EXPO held at The Venetian Macao’s Cotai Expo Hall, Professor Zhao Jiajun of Shandong Provincial Hospital Affiliated to Shandong First Medical University provided attendees with dual insights of both academic and clinical value by meticulously dissecting the core challenges in diabetes management from a clinician’s perspective.

Professor Zhao Jiajun, Shandong Provincial Hospital Affiliated to Shandong First Medical University

BEYOND EXPO 2025, Asia’s largest technology innovation and ecosystem expo, themed “Unveiling Possibilities,” attracted top tech companies and pioneers from around the world to push boundaries and deliver a premier event integrating cutting-edge technology with forward-thinking insights.

A set of data reflects the urgent need for diabetes management in China. According to the "IDF Global Diabetes Atlas," the prevalence of diabetes among adults in China is as high as 12.8%, and the proportion of people with prediabetes reaches 35.2%, with more than half of them in the prediabetic stage of type 2 diabetes. As a high-risk group, the prevalence rate among the elderly population is between 20% and 25%. If the prediabetic population is included, the proportion becomes even more alarming.

The harms of diabetes extend far beyond abnormal blood glucose levels; its various complications are the true “invisible killers.” Acute complications, such as ketoacidosis, can pose an immediate threat to life, while chronic complications caused by vascular diseases, including cardiovascular and cerebrovascular diseases and nephropathy, are the leading causes of disability and death. Even more concerning is that over 95% of patients with type 2 diabetes also suffer from hypertension and hyperlipidemia. The co-occurrence of these “three highs” undoubtedly exacerbates the health and economic burdens on individuals, families, and society.

Yet why does this major disease, which afflicts approximately 150 million people in China, remain mired in a management dilemma characterized by low awareness and low treatment rates?

Professor Zhao Jiajun pointed out incisively that the inefficiency in diabetes management essentially stems from a triple disconnect among cognition, systems, and technology.

At the cognitive level, the deeply entrenched notion of prioritizing treatment over prevention, coupled with an excessive focus on glycemic control and a lack of etiological interventions, has resulted in suboptimal rates of both treatment and target attainment.

At the systemic level, the lack of multidisciplinary collaboration and weak community support make it difficult to achieve full-cycle coverage from screening of high-risk populations to prevention and control of complications.

At the technical level, insufficient application of advanced technologies such as big data and artificial intelligence makes it difficult for diabetes management to meet individualized needs.

According to Professor Zhao Jiajun, although diabetes is preventable and controllable, achieving effective management requires breaking through the traditional limitation of “single-indicator control.” Clinical studies have shown that weight management is closely linked to glucose and lipid metabolism; weight loss can significantly improve blood glucose, blood lipid, and blood pressure levels. This serves as the scientific basis for the national “Three-Year Weight Management Initiative.” However, current diabetes management has fallen into a misconception, with excessive focus on blood glucose while neglecting root-cause factors such as dyslipidemia, obesity, and lifestyle.

Therefore, diabetes management must adopt a "holistic approach," incorporating weight, blood glucose, blood pressure, and blood lipids into comprehensive care, and shifting from "symptomatic treatment" to "etiological intervention," thereby truly improving the efficiency of diabetes management.

Professor Zhao Jiajun pointed out that to address the challenges in diabetes management, it is necessary to be guided by a holistic, systematic, and developmental perspective, and to construct a three-dimensional model featuring coordinated “prevention–diagnosis/treatment–support,” thereby achieving a transition from “single-focus glucose control” to multidimensional management.

Establishing a full-cycle management model for diabetes, with the implementation of the “Two Screenings, Three Preventions” strategy as the key.

“Two Screenings” refer to diabetes screening for high-risk populations and complication screening for individuals with diabetes, aiming for early detection, early intervention, and early treatment. “Three Preventions” target healthy individuals, patients with diabetes, and patients who have already developed complications, respectively adopting lifestyle interventions, standardized treatment with regular follow-ups, and active and effective therapeutic measures to prevent the onset of diabetes and its complications, halt the progression of complications, and reduce disability and mortality.

Improving the health management system can enhance the effectiveness of diabetes management.

On one hand, by establishing interdisciplinary teams that integrate expertise from endocrinology, nutrition, exercise science, and psychology, disciplinary barriers are broken down to provide patients with comprehensive, personalized treatment plans. While developing standardized intervention protocols, the team must also fully account for individual differences, such as the course of the disease, to make personalized adjustments. This therapeutic model, shifting from a single-dimensional approach to multidimensional integration, can offer patients more comprehensive and effective health support, thereby improving treatment outcomes.

Strengthening community support is a crucial measure to extend the reach of full-cycle diabetes management.

By establishing a closed-loop management system encompassing “hospital–community–home,” patient support groups and family caregiving networks are created in out-of-hospital settings, enabling diabetes management to transcend the limitations of hospital care and integrate into daily life. This seamless, continuous care model ensures that patients receive effective management and support across various settings, thereby improving treatment adherence.

Building an AI-powered full-cycle management system for chronic diseases, empowering every stage from prevention and diagnosis to long-term follow-up.

In disease screening, big data and artificial intelligence (AI) technologies are leveraged to analyze and mine vast amounts of diabetes-related data, enabling risk stratification, precision prevention, and intelligent decision-making for diabetes. In remote monitoring, patients with diabetes use digital health tools such as smart glucometers and blood pressure monitors to upload real-time data on blood glucose, heart rate, and sleep patterns to the cloud. AI systems automatically analyze this data and issue alerts for abnormalities, immediately notifying both patients and physicians when anomalies are detected. Furthermore, AI can predict disease progression trends based on patients’ historical data, providing personalized health recommendations and facilitating long-term follow-up care.

Policy and ecosystem optimization serve as the guarantee for the implementation of management models.Chronic disease management services, such as those for diabetes, are characterized by high demand, broad scope, and long duration. To promote the development of diabetes management services, innovative collaboration among all stakeholders in the ecosystem is required.

From a policy perspective, it is necessary to improve medical insurance policies by expanding reimbursement coverage for preventive services and comprehensive management, thereby reducing the financial burden on patients. On the healthcare service side, assessment and incentive mechanisms should be established for medical institutions to encourage them and their physicians to implement comprehensive management, facilitating a shift from a “treatment-focused” to a “prevention-focused” model. Meanwhile, talent development should be strengthened to enhance diabetes management capabilities across medical institutions at all levels.

Professor Zhao Jiajun emphasized that diabetes prevention and control are a critical component of the "Healthy China" initiative. The transition from "glucose-centric control" to "whole-cycle, multi-dimensional, and intelligent" management requires collaborative efforts involving medical model innovation, policy guidance, technological support, and social participation. Only by consistently upholding the principle that "every individual is the primary responsible party for their own health" and building an ecosystem where the government, healthcare sector, technology industry, and public work in synergy can we effectively curb the spread of diabetes and contribute to achieving the grand vision of "Healthy China 2030."