LAUSR

Over the past decade, epidemiologic studies have revealed a tremendous increase in the prevalence of diabetes and related mortality worldwide, especially in Asia. The general population-based survey in China in 2010, using the American Diabetes Association 2010 criteria, revealed that the prevalence of diabetes and prediabetes in adults was 11.6% and 50.1%, respectively, indicating that China has the highest diabetes prevalence in Asia and largest absolute disease burden of diabetes in the world. Lifestyle changes, aging, and obesity have become the main reasons for this increase in the prevalence of diabetes. Consequently, the economic burden is increasing accordingly. It was estimated that, in 2017, diabetes-related global healthcare expenditure was nearly US$850 billion for those aged 18 to 99 years, with the main reason for the high cost being the treatment of diabetes-related complications. In China, the economic expenditure caused by the diseases is greatly increased compared with decades ago, and is expected to rise in the future. In dealing with the prevention and treatment of diabetes, China has several challenges to face. First, in contrast with the high prevalence of diabetes, awareness of, adherence to treatment and control status among diabetic patients are relatively unsatisfactory, with the serious imbalance in the ratio of physicians to patients making it difficult to achieve early diagnosis and management of diabetes and its related complications. Second, the existing hospital treatment system can barely meet the needs of the rapidly increasing diabetes population. Patients with diabetes and other metabolic diseases need comprehensive examination and evaluation of possible complications, but the process from testing to diagnosis and to treatment is time consuming. Third, the Healthy China 2030 strategy (http://www.who.int/ healthpromotion/conferences/9gchp/healthy-china/en/, accessed 10 September 2018), released in 2016 by the State of China to improve the overall health of its citizens, is currently in progress and being actively promoted, and the management of chronic diseases (including diabetes, hypertension, and dyslipidemia) should be handled at different levels within a tiered medical services policy. Because there are gaps between recommended guidelines and the real-world care for diabetes in China due to wide variations in the economy, cultural development, and medical service standards in different regions, it is necessary to first establish a pilot and standard system to deal with the challenges that can be replicated and extended to different regions nationwide, and to then dynamically integrate advanced technologies into this system. In order to meet all the challenges in the treatment of metabolic diseases, the National Metabolic Management Center (MMC) was founded in 2016. With advanced medical equipment and Internet of Things (IoT) technology, the MMC is committed to creating an online and offline integrated solution for diabetes, and for the entire spectrum of metabolic disease, to achieve a more convenient and precise model of care for patients. The MMC is focused on establishing highly efficient diagnosis and treatment, as well as comprehensive disease management both in and out of hospital.