The current prevalence of diabetes in China is growing like a “tsunami”, which was predicted by foreign experts at last year’s National Diabetes Conference, and has been deeply felt by the daily congested outpatient clinics and patients waiting in line for hospitalization at the endocrine departments of hospitals. The reasons for this are not only the economic development and the great changes in lifestyle, which have led to a significant increase in the number of overweight and obese people, but also the greatly increased per capita life expectancy and the increasingly prominent aging. In our daily outpatient clinics, there are more and more elderly people, around eighty or even close to ninety years old, who still consult alone, and we often cannot help but sigh that social progress and medical prosperity have brought happiness to the people. However, at the same time, people’s perceptions are far from being fundamentally changed. Comparing the management of diabetes in hospitals in Taiwan with the same language and species, the gap is huge. First of all, most patients do not have the good habit of monitoring their condition, and the frequency of blood glucose and blood pressure measurement is far less than that of international developed countries, and there is even a lack of blood lipid, heart, fundus, kidney and other related examinations! Most of the hospital specialties also “treat the headache and the foot”, failing to comprehensively manage patients’ comprehensive risk factors such as blood glucose, blood pressure and blood lipids, so that we often see a patient who has had more than one stent for heart attack, but the blood glucose control has not been in place. For chronic diseases such as diabetes and hypertension that last for decades, it is not easy to insist on doing well for decades. Without a set of scientific management methods, the so-called health promotion is an empty talk, and even if the per capita life expectancy increases, it is inefficient. At present, we are almost in sync with, or even ahead of, the international developed countries in terms of the types of therapeutic drugs and treatment methods, but at a huge cost, we do not get the results to match them. It can be said that the physical quality of middle-aged people nowadays is far less than that of their parents’ generation. The reasons for this, in addition to many social complications, such as the environment, mental stress, poor lifestyle, etc., are very important or the deficiency in health management, a top-down deficiency, from concept to practice. Most of our patients are able to take medications for a long time, even expensive ones, but there is a lack of regular check-ups and evaluations, and many of them go to the hospital no different from going to the supermarket. Many doctors are also slowly being reduced to being pharmacy salesmen, just copying a prescription. As a result, despite the cost of medication, complications remain high and can even get worse because there is no mechanism to urge patients and doctors to have regular checkups and evaluations. Therefore, the national health department, medical insurance and hospital management must wake up and fully understand this serious problem, medical insurance reimbursement should set a reasonable ratio of drug costs and examinations, the examination ratio is too low, the amount of reimbursement correspondingly reduced, hospital management should also evaluate each outpatient doctor, especially the drug ratio, only so that doctors who can only prescribe drugs do not have a market, at the same time, should standardize the specialist outpatient, specialist outpatient, general outpatient At the same time, the number of visits to specialist clinics, specialist clinics and general clinics should be standardized to increase the number of outpatient doctors to ensure that patients have a reasonable consultation time, many hospitals now have specialist clinics often half a day fifty to sixty patients, such as no time to fully understand the condition, no assessment based on the examination of the condition, a few words after a hasty prescription, its quality can be imagined. The poor patients, spending huge time and economic costs, but not get the treatment they deserve. When I visited a hospital in Taiwan and saw the orderly outpatient consultation, the consultation room to guide patients, and the web-based consultation management system with dedicated staff on duty, I was deeply impressed by the huge gap, not in terms of economics, but in terms of philosophy. The neglect of patient education by our health insurance is also one of the reasons why patients do not pay attention to it. Imagine if each patient with diabetes, hypertension and other chronic diseases had to receive how many hours of patient education each year in order for Medicare to give a better amount of reimbursement settlement, and physicians involved in patient education not only have to be rated and have credentials, but also have to charge, can patients not pay attention? Of course, the cost of patient education consultations must and should be reimbursed by Medicare, which is much more important than the cost of medicine from a certain point of view. My outpatient and ward visits are now more about teaching patients how to see their patients properly and how to learn to manage their health problems. Only by truly recognizing the core problems of chronic disease management in China today, changing the philosophy and raising awareness, can health promotion be put on the right track. Only then will doctors have the desire to improve their skills, and only then will patients be able to receive effective diagnosis and treatment commensurate with their or the country’s input!