Introduction

Insulin is a hormone that is released from the pancreas to facilitate the storage of glucose as glycogen and triglyceride in the body. Diabetes mellitus is a chronic disorder characterized by a raised blood glucose level resulting from insulin deficiency, insulin resistance or both. In Type I or insulin-dependent diabetes (IDDM), little or no insulin is produced. In Type II or non-insulin-dependent diabetes (NIDDM), there is reduced insulin secretion and the body cells do not react to insulin. Diabetes increases the risk of cerebrovascular disease, heart diseases, foot gangrene, retinopathy, nephropathy and neuropathy.

Situation in Hong Kong

Classification of diseases and causes of death is based on the International Statistical Classification of Diseases and Related Health Problems (ICD) 10th Revision from 2001 onwards. Figures from 2001 onwards may not be comparable with figures for previous years which were compiled based on the ICD 9th Revision. Hence, caution should be exercised when interpreting the trend of diseases across 2000 and 2001.

Diabetes mellitus corresponds to codes 250 in ICD-9 and E10-E14 in ICD-10.

Diabetes is a major cause of morbidity and mortality in Hong Kong. It claimed about 25 500 in-patient discharges and deaths in all hospitals and 492 deaths in 2009. It was the tenth commonest cause of deaths in Hong Kong, accounting for 1.2% of all deaths in 2009. The crude death rates were 6.5 for male and 7.5 for female per 100 000 population of respective sex in 2009. The true number of deaths from diabetes is possibly higher since many deaths can be attributed to its late complications. Age-standardized death rates were 4.0 for male and 3.8 for female per 100 000 standard population in 2009. From early 1980's to 2000, the age standardized mortality rate showed a general increasing trend but decreased slightly from 2001. Based on Population Health Survey 2003/04, 3.8% of people aged 15 and above reported that they had doctor-diagnosed diabetes.

Age-standardized death rate* of diabetes mellitus
by sex, 2001-2009

Symptoms

People with diabetes are often asymptomatic. They can be diagnosed by checking blood glucose level during medical examination. As the disease develops, diabetes may present with symptoms or complications. Possible symptoms include thirst, excessive urination, increased appetite, weight loss, lethargy, poor wound healing and infections. Uncontrolled diabetes causes acute conditions such as severe dehydration and coma.

Risk factors

Some risk factors for diabetes include advancing age, obesity, family history of diabetes and lack of physical activity. Diabetes can also be predisposed by some endocrine diseases, pancreatic diseases and drugs e.g. steroids.

Prevention

To prevent diabetes, one should maintain an optimum body weight through a balanced diet and regular physical activity. Diabetic patients should have their blood sugar under control through dietary or pharmacological measures.

Related information

For more information on diabetes, please visit the website of our Health Zone and the Hong Kong Reference Framework for Diabetes Care for Adults in Primary Care Settings (for health care professionals).