Meeting the Challenge of Diabetes in China

China’s estimated 114 million people with diabetes pose a massive challenge for China’s health policy-makers who have significantly extended health insurance coverage over the past decade. What China is doing now, what it has achieved, and what remains to be done should be of interest to health policy-makers, worldwide. We identify the challenges posed by China’s two principal strategies to tackle diabetes: (1) A short-term pilot strategy of health promotion, detection and control of chronic diseases in 265 national demonstration areas (NDAs); and (2) A long-term strategy to extend health promotion and strengthen primary care capacity and health system integration throughout China. Finally, we consider how Chinese innovations in artificial intelligence (AI) and Big Data may contribute to improving diagnosis, controlling complications and increasing access to care. Health system integration in China will require overcoming the fragmentation of a system that still places excessive reliance on local government financing. Moreover, what remains to be done resembles deeper challenges faced by healthcare systems worldwide: the need to upgrade primary care and reduce inequalities in access to health services.