Diabetes is a silent killer. According to the International Diabetes Federation (IDF) latest 2021 IDF Diabetes Atlas (10th edition)[1], 1 in 10 adults aged between 20-79 are living with diabetes worldwide, and 1 in 4 is from China. Over the past 10 years (2011-2021), the number of diabetic patients in China has increased by 56%, from 90 million to 140 million, and diabetes-related medical expenditures are reaching over USD160 billion. With the growing aging population, chronic diseases associated with diabetes will not only affect people’s well-being, but also place a greater financial burden on the country.

At the 2021 AI in Healthcare Seminar recently hosted by Yidu Tech, Professor Li Guangwei, a renowned endocrinology and diabetes expert in China, and the leading researcher of the 30-year Daqing study in China (a milestone study in the world’s primary prevention of diabetes), delivered a speech on the topic of “Artificial Intelligence (AI) Intervention in Type 2 diabetes Patient Management under the New Pandemic Normal”. He noted, “Our long-term research has shown that lifestyle improvements can effectively control or reverse diabetes progression. I believe that as technology evolves, AI will be used effectively to enhance patient education and promote lifestyles changes. At the same time, AI will also accelerate information processing and output feedback to help healthcare professionals service patients in a larger scale, reduce their workloads and address more clinical pain points. This is of great significance to hundreds of millions of diabetic and prediabetic patients as well as their families in China.”

The key messages of Professor Li's speech are as follows:

The dangers of diabetes

Statistically, diabetes reduces life expectancy by 10 years in average in Northern China. In addition to cardiovascular death and all-cause mortality, kidney failure and blindness are also major threats to diabetes patients. Only about 55% of the diabetic population are without any complications, and nearly half also suffer from four major metabolic diseases, including cardiovascular disease, hypertension, hyperlipidemia, and obesity, which greatly increasing the medical expenses of these patients.

Lifestyle improvement is the effective intervention

The medical community has reached a consensus that diabetes is a lifestyle disease. It is believed that genetics is not the main determinant of diabetes, on the other hand, an unhealthy lifestyle plays a major role in the development of the disease. Take obesity as an example, people who are chronically obese will develop insulin resistance, causing an imbalance in the secretion of glucagon and insulin in the body that will lead to glucose and lipid metabolism problems and a series of complications. Therefore, one of the key diabetes interventions advocated worldwide is weight reduction. Studies have demonstrated that by losing 12% of body weight, 60% of diabetic patients can get remission or have their blood sugar level returned to normal.

With the general improvement of living standards and an aging population, the spread of diabetes has accelerated in China. It is paramount to promote the improvement and reversal of diabetes by starting with lifestyle changes. Lifestyle intervention is also a treatment that can reduce glycoprotein by 1-2%. Taking the Daqing study as an example, after 6 years of lifestyle intervention, the incidence of diabetes was reduced by half, and the cardiovascular diseases and the blindness rate of the participants also decreased by 27% and 66% respectively.

How does lifestyle intervention cure diabetes? First of all, exercise can increase insulin sensitivity, adjust hormone secretion and reduce stress; in terms of diet, reducing total calories and carbohydrates intake on a daily basis can significantly improve blood sugar control. A European study in recent years showed that 60% and 80% of newly diagnosed diabetic patients were able to return to non-diabetes glucose level without taking medication, by weight loss of 10 kg and 15 kg respectively.

The industry pain points that AI is expected to solve

It is not easy to get patients to proactively change their lifestyle. This is especially true when medical resources are already scarce and healthcare professionals are too wrapped up in the daily treatments and consultations to be able to follow up and provide guidance to all patients. “I very much look forward to the development of AI technology to assist doctors in guiding and monitoring patients’ behavior. Combined with the information from wearable devices such as heart rate, blood pressure, and blood glucose, AI can provide tailor-made health management and treatment plans for patients. In addition, after getting proper authorizations and consents, we may also be able to conduct intelligent data processing and perform machine learning on the data collected by these devices through AI technology to help doctors with subsequent diagnosis and prescription of medication. With the development of technology, I believe AI will effectively support healthcare professionals to serve more patients, reduce their burden and solve more clinical pain points.”

Professor Li Guangwei is China’s endocrinology and diabetes expert, and the host and participant of the 30-year Daqing study in China (a milestone study in the world’s primary prevention of diabetes). He is the former vice chairman of the Endocrinology and Cardiovascular Disease Diagnosis and Treatment Center of Fuwai Cardiovascular Hospital, Chinese Academy of Medical Sciences, and an expert with outstanding contributions to the State Council. His main research areas are the prevention and control of diabetes and cardiovascular and cerebrovascular diseases in diabetes. He was the former Vice Chairman of the Chinese Society of Endocrinology. He is also a member of the Expert Committee of Centre for Disease Prevention and Control of the Ministry of Health, and the Review Committee of New and Imported Drug of the National Medical Products Administration. In addition, he is the chief deputy editor of the Chinese Journal of Endocrinology and Metabolism, and an editorial board member of many medical journals such as the Chinese Journal of Internal Medicine.