Diabetes Prevalence among Older Adults in China: a Systematic Review and Meta-analysis

doi:10.12114/j.issn.1007-9572.2025.0426

Chinese General Practice ›› 2026, Vol. 29 ›› Issue (24): 3500-3508.DOI: 10.12114/j.issn.1007-9572.2025.0426

Special Issue: 内分泌代谢性疾病最新文章合辑

• Article·Study of Evidence-based Medicine • Previous Articles Next Articles

Diabetes Prevalence among Older Adults in China: a Systematic Review and Meta-analysis

1. Department of Metabolism and Endocrinology, the Second Xiangya Hospital of Central South University/Key Laboratory of Diabetes Immunology, Ministry of Education/National Clinical Research Center for Endocrine and Metabolic Diseases, Changsha 410011, China
2. Department of Plastic Surgery, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, China
3. Department of Gastroenterology, the Second Xiangya Hospital of Central South University, Changsha 410011, China
4. Xiangtan Institute of Health Education, Xiangtan 411100, China
5. Department of Breast Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China

Received:2025-09-10 Revised:2025-12-20 Published:2026-08-20 Online:2026-07-03
Contact: LUO Shuoming

中国老年人糖尿病患病率：一项系统综述和Meta分析

1．410011　湖南省长沙市，中南大学湘雅二医院代谢内分泌科　糖尿病免疫学教育部重点实验室　内分泌与代谢性疾病国家临床医学研究中心
2．322000　浙江省义乌市，浙江大学医学院附属第四医院整形外科
3．410011　湖南省长沙市，中南大学湘雅二医院消化内科
4．411100　湖南省湘潭市健康教育所
5．410011　湖南省长沙市，中南大学湘雅二医院乳腺外科

通讯作者: 罗说明
作者简介:
作者贡献：
王睿和罗说明负责研究的构思与设计；王睿完成文献检索、筛选、数据提取与统计分析，并撰写论文初稿；杨靓、王鹏独立进行文献筛选与数据提取；赵洋、王淇参与数据核对、偏倚风险评价及结果解释；周智广对论文的重要学术内容进行了关键性修改，并对研究整体进行指导。所有作者阅读并同意论文最终稿。
基金资助:
国家重点研发计划(2022YFC3603000); 湖南省卫生健康高层次人才重大科研专项(R2023044)

Abstract

Abstract:

Background

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.

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

Key words: Aged, Diabetes mellitus, Prevalence, Systematic review, Meta-analysis, Epidemiology

摘要：

背景

在中国人口老龄化与糖尿病患病率持续上升的背景下，老年糖尿病所带来的健康和社会经济负担不断加剧。尽管我国已有多项研究报道老年人群糖尿病患病率，但相关证据分散，尚缺乏系统评价和Meta分析对其流行状况进行综合量化。全面了解该人群的糖尿病流行状况，是推动针对性防控措施、优化卫生资源布局的重要前提。

目的

按照系统评价与Meta分析规范，系统检索中英文数据库，纳入2000—2023年发表的我国老年人（≥60岁）糖尿病患病率研究，并采用Meta分析方法对患病率进行合并估计及亚组分析。

方法

系统检索中英文数据库（包括中国知网、万方数据知识服务平台、PubMed、Embase、Web of Science、Scopus数据库），收集2000—2023年发表的与我国老年糖尿病患病率相关的研究文献。采用Stata软件进行Meta分析，使用I²评估异质性，并根据结果选择固定效应模型或随机效应模型，合并计算总体及亚组患病率。

结果

本研究纳入20篇文献，包括872 633名受试者，涵盖31个省（自治区、直辖市）的老年人群。Meta分析结果显示，中国老年人糖尿病患病率为18.67%（95%CI=15.86%~21.47%），剔除标化率后的粗患病率为19.22%（95%CI=16.15%~22.30%）。男性患病率为18.20%（95%CI=14.74%~21.66%），女性患病率为19.06%（95%CI=15.98%~22.13%）。按年龄分层，60~69岁人群糖尿病患病率为17.6%（95%CI=13.73%~21.47%），70~79岁为19.62%（95%CI=13.51%~25.73%），≥80岁为19.52%（95%CI=15.41%~23.63%）。城市老年人糖尿病患病率为16.85%（95%CI=11.21%~22.50%），高于农村居民的14.20%（95%CI=8.97%~19.42%）。按受教育水平分层，初中及以上学历人群为18.58%（95%CI=15.84%~21.31%），小学及以下为13.93%（95%CI=9.18%~18.68%）。按BMI分层，BMI<18.5 kg/m²、18.5~23.9 kg/m²、24.0~27.9 kg/m²、≥28.0 kg/m²人群的糖尿病患病率分别为14.46%（95%CI=5.75%~23.16%）、17.73%（95%CI=14.60%~20.86%）、29.15%（95%CI=17.40%~40.90%）和31.74%（95%CI=22.65%~40.83%）。敏感性分析结果稳定，未发现明显发表偏倚。

结论

2000—2023年间中国老年人群糖尿病患病率高达18.67%。不同性别、年龄、城乡、受教育水平及BMI亚组间糖尿病患病率存在差异。总体上，女性患病率略高于男性，患病率随年龄增长呈上升趋势；城市老年人患病率高于农村人群，受教育水平较高者患病率高于受教育水平较低者。不同BMI亚组间差异尤为显著，超重及肥胖老年人群糖尿病患病率明显高于体质量正常及偏低人群。

关键词: 老年人, 糖尿病, 患病率, 系统综述, Meta分析, 流行病学

WANG Rui,LUO Shuoming,YANG Liang, et al. Diabetes Prevalence among Older Adults in China: a Systematic Review and Meta-analysis[J]. Chinese General Practice, 2026, 29(24): 3500-3508. DOI: 10.12114/j.issn.1007-9572.2025.0426.
王睿,罗说明,杨靓等. 中国老年人糖尿病患病率：一项系统综述和Meta分析[J]. 中国全科医学, 2026, 29(24): 3500-3508. DOI: 10.12114/j.issn.1007-9572.2025.0426.

Figures/Tables 5

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第一作者	调查时间（年）	调查地区	检验标准	样本量（例）	年龄（岁）	患病率（%）
张晗^[8]	2015	北京市、上海市、湖北省、四川省、云南省、广西壮族自治区	WHO	23 718	≥60	18.25
刘依婷^[9]	2019	南京市	自报糖尿病	1 552	≥60	21.52
Liu^[10]	2001	北京市	WHO	2 277	≥60	21.40
Liu^[10]	2010	北京市	WHO	2 102	≥60	24.80
Feng^[11]	2020	广东省中山市	自报糖尿病	9 519	≥60	15.50
Liang^[12]	2015—2016	四川省成都市	WHO	1 326	≥80	27.40
Wang^[13]	2009—2010	北京市	WHO	2 102	≥60	24.80
Zhao^[14]	2015—2016	海南省海口市	自报糖尿病	9 371	≥60	8.00
Hu^[15]	2015	466个县（区）	WHO	215 041	≥60	8.70
Yan^[16]	2018	武汉市	WHO	376 702	≥65	18.80
Sun^[17]	2018	广东省深圳市	WHO	124 007	≥65	22.50
Zhao^[18]	2019	云南省昆明市	WHO	3 225	≥60	17.90
刘淼^[19]	2014—2016	海南省	WHO	1 002	≥100	9.50
吕金芳^[20]	2019	海南省	WHO	12 582	≥60	30.52
卢泰旭^[21]	2019—2021	吉林省	WHO	559	≥65	30.60
任福荣^[22]	2015	上海市	WHO	4 769	≥60	20.80
王瑶^[23]	2011	天津市	WHO	6 404	>60	19.07
王瑶^[23]	2012	天津市	WHO	7 299	>60	21.32
王瑶^[23]	2013	天津市	WHO	7 077	>60	25.28
张黎明^[24]	2005	吉林省长春市	自报糖尿病	862	≥60	10.70
付萍^[25]	2002	31个省（自治区、直辖市）132个调查点	WHO	9 925	≥60	6.83
王丽敏^[26]	2016	31个省（自治区、直辖市）298个县（区）	WHO	51 383	≥60	19.40
"珠海市人口老龄化现况调查及对策研究"课题组^[27]	2013—2014	广东省珠海市	WHO	1 109	>60	10.40
"珠海市人口老龄化现况调查及对策研究"课题组^[27]	2009—2010	吉林省	WHO	1 945	>60	15.00

第一作者	调查时间（年）	调查地区	检验标准	样本量（例）	年龄（岁）	患病率（%）
张晗^[8]	2015	北京市、上海市、湖北省、四川省、云南省、广西壮族自治区	WHO	23 718	≥60	18.25
刘依婷^[9]	2019	南京市	自报糖尿病	1 552	≥60	21.52
Liu^[10]	2001	北京市	WHO	2 277	≥60	21.40
Liu^[10]	2010	北京市	WHO	2 102	≥60	24.80
Feng^[11]	2020	广东省中山市	自报糖尿病	9 519	≥60	15.50
Liang^[12]	2015—2016	四川省成都市	WHO	1 326	≥80	27.40
Wang^[13]	2009—2010	北京市	WHO	2 102	≥60	24.80
Zhao^[14]	2015—2016	海南省海口市	自报糖尿病	9 371	≥60	8.00
Hu^[15]	2015	466个县（区）	WHO	215 041	≥60	8.70
Yan^[16]	2018	武汉市	WHO	376 702	≥65	18.80
Sun^[17]	2018	广东省深圳市	WHO	124 007	≥65	22.50
Zhao^[18]	2019	云南省昆明市	WHO	3 225	≥60	17.90
刘淼^[19]	2014—2016	海南省	WHO	1 002	≥100	9.50
吕金芳^[20]	2019	海南省	WHO	12 582	≥60	30.52
卢泰旭^[21]	2019—2021	吉林省	WHO	559	≥65	30.60
任福荣^[22]	2015	上海市	WHO	4 769	≥60	20.80
王瑶^[23]	2011	天津市	WHO	6 404	>60	19.07
王瑶^[23]	2012	天津市	WHO	7 299	>60	21.32
王瑶^[23]	2013	天津市	WHO	7 077	>60	25.28
张黎明^[24]	2005	吉林省长春市	自报糖尿病	862	≥60	10.70
付萍^[25]	2002	31个省（自治区、直辖市）132个调查点	WHO	9 925	≥60	6.83
王丽敏^[26]	2016	31个省（自治区、直辖市）298个县（区）	WHO	51 383	≥60	19.40
"珠海市人口老龄化现况调查及对策研究"课题组^[27]	2013—2014	广东省珠海市	WHO	1 109	>60	10.40
"珠海市人口老龄化现况调查及对策研究"课题组^[27]	2009—2010	吉林省	WHO	1 945	>60	15.00

第一作者	刊出年份（年）	条目											总分（分）
第一作者	刊出年份（年）	①	②	③	④	⑤	⑥	⑦	⑧	⑨	⑩	⑪	总分（分）
张晗^[8]	2019	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
刘依婷^[9]	2022	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
Liu^[10]	2016	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
Feng^[11]	2023	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
Liang^[12]	2020	Y	Y	Y	Y	N	N	Y	Y	N	Y	N	7
Wang^[13]	2016	Y	Y	Y	Y	N	N	Y	N	N	Y	N	6
Zhao^[14]	2018	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
Hu^[15]	2022	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
Yan^[16]	2022	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
Sun^[17]	2020	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
Zhao^[18]	2023	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
刘淼^[19]	2021	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
吕金芳^[20]	2022	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
卢泰旭^[21]	2022	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
任福荣^[22]	2017	Y	Y	Y	Y	N	N	Y	N	N	Y	N	6
王瑶^[23]	2015	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
张黎明^[24]	2007	Y	Y	Y	Y	N	N	Y	N	N	Y	N	6
付萍^[25]	2007	Y	Y	Y	Y	N	N	Y	N	N	Y	N	6
王丽敏^[26]	2019	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
"珠海市人口老龄化现况调查及对策研究"课题组^[27]	2016	Y	Y	Y	N	N	Y	N	Y	N	Y	N	6

第一作者	刊出年份（年）	条目											总分（分）
第一作者	刊出年份（年）	①	②	③	④	⑤	⑥	⑦	⑧	⑨	⑩	⑪	总分（分）
张晗^[8]	2019	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
刘依婷^[9]	2022	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
Liu^[10]	2016	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
Feng^[11]	2023	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
Liang^[12]	2020	Y	Y	Y	Y	N	N	Y	Y	N	Y	N	7
Wang^[13]	2016	Y	Y	Y	Y	N	N	Y	N	N	Y	N	6
Zhao^[14]	2018	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
Hu^[15]	2022	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
Yan^[16]	2022	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
Sun^[17]	2020	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
Zhao^[18]	2023	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
刘淼^[19]	2021	Y	Y	Y	Y	N	Y	Y	Y	N	Y	N	8
吕金芳^[20]	2022	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
卢泰旭^[21]	2022	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
任福荣^[22]	2017	Y	Y	Y	Y	N	N	Y	N	N	Y	N	6
王瑶^[23]	2015	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
张黎明^[24]	2007	Y	Y	Y	Y	N	N	Y	N	N	Y	N	6
付萍^[25]	2007	Y	Y	Y	Y	N	N	Y	N	N	Y	N	6
王丽敏^[26]	2019	Y	Y	Y	Y	N	Y	Y	N	N	Y	N	7
"珠海市人口老龄化现况调查及对策研究"课题组^[27]	2016	Y	Y	Y	N	N	Y	N	Y	N	Y	N	6

特征	文献数	患病率（%）	95%CI（%）	异质性检验
特征	文献数	患病率（%）	95%CI（%）	I²（%）	P值
性别
男	17	18.20	14.74~21.66	99.9	<0.001
女	19	19.06	15.98~22.13	99.8	<0.001
年龄
60~69岁	7	17.60	13.73~21.47	99.7	<0.001
70~79岁	7	19.62	13.51~25.73	99.5	<0.001
≥80岁	8	19.52	15.41~23.63	99.0	<0.001
居住地
城市	6	16.85	11.21~22.50	99.6	<0.001
农村	6	14.20	8.97~19.42	99.8	<0.001
受教育水平
小学及以下	7	13.93	9.18~18.68	99.9	<0.001
初中及以上	7	18.58	15.84~21.31	97.1	<0.001
BMI
<18.5 kg/m²	4	14.46	5.75~23.16	96.8	<0.001
18.5~23.9 kg/m²	4	17.73	14.60~20.86	98.4	<0.001
24.0~27.9 kg/m²	4	29.15	17.40~40.90	99.7	<0.001
≥28.0 kg/m²	4	31.74	22.65~40.83	98.3	<0.001
检验标准
WHO	20	19.62	16.49~22.75	99.9	<0.001
自报糖尿病	4	13.89	8.45~19.34	99.2	<0.001

Diabetes Prevalence among Older Adults in China: a Systematic Review and Meta-analysis

中国老年人糖尿病患病率：一项系统综述和Meta分析

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