Against the backdrop of China's ageing population and persistently rising diabetes prevalence, the health and socio-economic burden posed by diabetes among the elderly continues to intensify. Although multiple studies in China have reported diabetes prevalence among older adults, the evidence remains fragmented, lacking systematic reviews and meta-analyses to comprehensively quantify its epidemiological status. A thorough understanding of diabetes prevalence in this population is a crucial prerequisite for advancing targeted prevention and control measures and optimising the allocation of healthcare resources.

In accordance with systematic review and meta-analysis protocols, a systematic search of Chinese and English databases was conducted to identify studies published between 2000 and 2023 investigating diabetes prevalence among Chinese older adults (≥60 years). A meta-analysis was performed to synthesise prevalence estimates and conduct subgroup analyses.

A systematic search of Chinese and English databases (including CNKI, Wanfang Data, PubMed, Embase, Web of Science, and Scopus) was conducted to collect research literature published between 2000 and 2023 concerning the prevalence of diabetes among elderly individuals in China. Meta-analysis was performed using Stata software, with I² used to assess heterogeneity. Based on the results, either a fixed-effect model or random-effects model was selected to combine and calculate the overall prevalence and prevalence within subgroups.

This study included 20 publications, encompassing 872 633 participants from elderly populations across 31 provinces. Meta-analysis results indicated that the prevalence of diabetes among Chinese older adults was 18.67% (95%CI=15.86%-21.47%). After excluding standardised rates, the crude prevalence was 19.22% (95%CI=16.15%-22.30%). The prevalence rate was 18.20% (95%CI=14.74%-21.66%) among males and 19.06% (95%CI=15.98%-22.13%) among females. By age group, the prevalence among those aged 60-69 years was 17.60% (95%CI=13.73%-21.47%), 19.62% (95%CI=13.51%-25.73%) among those aged 70-79 years, and 19.52% (95%CI=15.41%-23.63%) among those aged≥80 years. The prevalence among urban elderly residents was 16.85% (95%CI=11.21%-22.50%), higher than that among rural residents at 14.20% (95%CI=8.97%-19.42%). By educational attainment, the prevalence was 18.58% (95%CI=15.84%-21.31%) among those with junior secondary education or above, and 13.93% (95%CI=9.18%-18.68%) among those with primary education or below. Stratified by BMI, the prevalence rates among individuals with BMI <18.5 kg/m², 18.5-23.9 kg/m², 24.0-27.9 kg/m², and≥28.0 kg/m² were 14.46% (95%CI=5.75%-23.16%), 17.73% (95%CI=14.60%-20.86%), 29.15% (95%CI=17.40%-40.90%), and 31.74% (95%CI=22.65%-40.83%), respectively. Sensitivity analyses yielded stable results, with no evidence of significant publication bias.

The prevalence of diabetes among the elderly population in China reached 18.67% between 2000 and 2023. Differences in diabetes prevalence were observed across gender, age, urban-rural location, educational attainment, and BMI subgroups. Overall, the prevalence was slightly higher among women than men, and increased with advancing age. Urban elderly individuals exhibited higher prevalence than their rural counterparts, while those with higher educational attainment had higher rates than those with lower educational attainment. Differences were particularly pronounced across BMI subgroups, with significantly higher diabetes prevalence among overweight and obese elderly individuals compared to those of normal or underweight status.