Feasibility and priority strategies for diabetes prevention and control in Chinese demonstration areas

Background Diabetes is a leading global public health challenge with 537 million cases worldwide in 2021 and significant economic and societal burdens. Despite global initiatives, feasibility constraints limit widespread implementation of diabetes prevention/control measures. The key to facilitating the implementation of diabetes prevention and control measures lies in prioritise them. Objectives This study aimed to determine the priority of diabetes prevention and control measures in China from the feasibility perspective. Methods From January to February 2021, an online survey was administered to professionals specifically responsible for implementing chronic disease prevention and control programs in 488 national demonstration areas in China. The survey assessed the importance and feasibility of 44 diabetes prevention and control measures across 10 dimensions. The Importance-Performance Analysis (IPA) model categorized these indicators into four quadrants: Highest Priority (high importance and feasibility), Priority Improvement (high importance, low feasibility), Lowest Priority (low importance and feasibility), and Secondary Improvement (low importance, high feasibility). Results Quadrant 1 (‘Highest Priority’) included health education, community action, high-risk discovery and intervention, and medical insurance and family doctors, which should be maintained and strengthened. Quadrant 2 (‘Priority Improvement’) included patient management and complication screening, necessitating targeted efforts to enhance implementation. Quadrant 3 (‘Lowest Priority’) included personal health services assessment follow-up, environmental support, sugar reduction policy, and diabetes co-infection prevention, indicating a risk of overinvestment. No indicators were categorized into Quadrant 4 (‘Secondary Priority’). Conclusions Prioritizing diabetes prevention and control measures based on feasibility maximizes the utilization of limited resources, providing implementable recommendations for policymakers.