World Health Day7 April 2016

Let’s beat diabetesDr CHAN Hon-yee, Constance

Director of Health

World Health Day 2016• World Health Day is celebrated on 7 April every year

to mark the anniversary of the founding of the World Health Organization (WHO) in 1948

• Each year a theme is selected to highlight a priority area of public health concern

• The theme for World Health Day 2016 is Diabetes

2

Diabetes

• An endocrine disorder• Two major forms:

Type 1 diabetes mellitus: due to genetic and autoimmune factorsType 2 diabetes mellitus: due to genetic factors, unhealthy eating habit, physical inactivity and obesity

3

Pancreas

Complications of diabetes• Diabetes is a chronic disease. If it is not properly controlled with

glucose level remains high over a prolonged period and unstable, it can lead to acute or chronic complications

• About 40% (43%) of patients with high blood glucose died prematurely, before the age of 70 years

4

diabetic retinopathy

heart disease

stroke

renal failure

diabetic foot

Global situation‧Number of adults with diabetes has almost quadrupled from

108 million in 1980 to 422 million in 2014

‧ In 2014, 8.5% of adults had diabetes

‧ In 2012, diabetes led to 1.5 million deaths

‧Diabetes is going to become the 7th leading cause of death in 2030

‧ In 2014, more than 1 in 3 adults were overweight and more than 1 in 10 were obese

‧Type 2 diabetes accounts for vast majority of all diabetes, and is largely due to excess body weight and physical inactivity

5

Local situation

6

• Diabetes diagnosed by practitioners of Western medicine

Year No. of patients (% of total population)2008 257,700 (4.5%)2009/10 277,500 (4.1%)2011/12 337,600 (5.0%)2014 331,300 (4.8%)

Source: Thematic Household Survey Report, Census and Statistics Department

“Rule of halves” in diabetes

7Source: Heart Health Survey 2004/2005, Department of Health

43.3%Unaware of

having diabetes

56.7%History of diabetes

8

• Number of new DM cases consulted at Hospital Authority

Source: Hospital Authority

Impact of healthcare services

9

• Total number of DM patients consulted at Hospital Authority

No. of DM patients increased by more than          90,000 (31.5%)  in 5 years 

Source: Hospital Authority

Impact of healthcare services

Gestational diabetes• Pregnant women with gestational diabetes

10

Year Percentage1986 7.4%1994-1996 12.1%1998-2001 10.4%2000-2006 14.4%

Source： Hirst JE et al. J Diabetology 2012: 3:4Sacks DA et al. Diab Care 2012; 35:526-528

• Type 1 DM incidence rates for children under the age of 15 years

11

Year Incidence rates (per 100,000 person)

1997 1.72007 2.5

• Type 2 DM incidence rates for children under the age of 19 years

Year Incidence rates (per 100,000 person)

1997 0.22007 2.6

Childhood diabetes

Source： Huen KF et al. HK J Paediatr (New Series) 2009;14:252-259

Local situation• In Hong Kong, about 1 in every 10 people (10%) has diabetes

– About half (43.3%) are unaware that they have diabetes

• 1 in every 5 diabetic patients (21.3%) had onset of diabetes before age of 40 years*

• Increasing burden due to diabetes:

– Number of diabetic patients at HA’s out-patient clinics

– Pregnant women with gestational diabetes

– Childhood diabetes

*Source：Chan JCN et al. Am J Med 2014;127(7):616-624

12

Overweight and obesity in adults

13

Adult (18-64 years) (Body mass index≥ 23)

Source: Behavioural Risk Factors Survey, Centre for Health Protection, Department of Health

(BMI ≥ 23)

女性男性 合計

年份

百分率

Year

Male Female Overall

Perc

enta

ge

簡報者簡報註解

14

Central obesity‧Local 3-year follow-up survey using

Population Health Survey data in 2003/04

Central obesity (waist circumference ≥ 90cm for male and ≥80cm for female)

Ho LM, Wang MP, Ho SY, Lam TH PLoS ONE 2015;10(3):e0119827

28.3%23.0%

33.0%32.4%

26.1%

38.1%

0%5%

10%15%20%25%30%35%40%45%

All Male Female

Baseline(Year 2003)

3-year follow-up(Year 2006)

p

15

Overweight and obesity

18.7%

22.2% 22.2%

18.7%

22.8%

27.1% 27.0%

23.0%

14.5%

17.0% 17.0%

14.1%

0%

5%

10%

15%

20%

25%

30%

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15

Both sexes Boys Girls

Primary school students

16

Overweight and obesitySecondary school students

15.8%

19.4%18.6%

22.2%

13.6%

16.6%

0%

5%

10%

15%

20%

25%

2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 * 2010/11 2011/12 2012/13 2013/14 2014/15

Both sexes Boys Girls

17

Eating habitSoft drinks or sugary beverages

Note: All respondents excluding “don’t know” and refusal = 4 247Source: Behavioural Risk Factors Survey (April 2015), Centre for Health Protection, Department of Health

%

More than once a day

4-6 times a week

1-3 times a week

Less than once a week

Did not drink soft drinks or sugary

beverages

18

Note: All respondents excluding “don’t know” and refusal = 4 246Source: Behavioural Risk Factors Survey (April 2015), Centre for Health Protection, Department of Health

%

Eating habitDesserts or snacks high in sugar

More than once a day

4-6 times a week

1-3 times a week

Less than once a week

Did not eat desserts or snacks that were high

in sugar

Physical inactivity

64.2% 62.5%

0%

20%

40%

60%

80%

2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Perc

enta

ge (

%)

Year

Percentage of general public who are physically inactive

decreasing trend

19Source: Behavioural Risk Factors Survey, Centre for Health Protection, Department of Health

Let’s beat diabetes

20

More fruits and vegetablesLow sugarLow saturated fat

At least 30 minutes of moderate-intensity physical activity a day, 5 days a week

Let’s beat diabetes

21

Many patients may not have any symptoms or signsConsult your family doctor if in doubt

Healthy eatingRegular physical activityTake prescribed drugs properlyControl blood pressureAvoid smoking

Risk factors of diabetes

22

Aged 45 or above Family history of diabetesin first degree relatives

Risk factors of diabetes

23

Obese: BMI 25 or aboveOverweight: BMI 23-24.9

Male: 90cm or aboveFemale: 80cm or above

Do you have central obesity

Lower border of the rib cage

Top of the hipbone

Measuring tape position

24

World Health DayPublicity campaign

• Thematic websitehttp://www.chp.gov.hk/en/view_content/43772.html

25

http://www.chp.gov.hk/en/view_content/43772.html

World Health Day Health education materials

26

Diabetes-friendly recipes (suitable for diabetic patients)

Cooking demonstration at YouTubeBesides Cantonese and English, Thai

and Indonesian are newly added

27

World Health DayHealth education materials

New

World Health DayHealth education materials

Diabetes-friendly recipes (Indonesian)

video

28

• Designed by Physical Fitness Association of Hong Kong, China

• Moderate-intensity physical activity suitable in workplace and home settings

video

29

“Ten-minute Exercise”

Key partners

Centre for Food SafetyFood and Environmental

Hygiene Department

30

Diabetes Hongkong

• College of Ophthalmologists of Hong Kong• Education Bureau• Hong Kong Academy of Medicine• Hong Kong College of Community Medicine• Hong Kong College of Family Physicians• Hong Kong College of Orthopaedic Surgeons• Hong Kong College of Paediatricians• Hong Kong College of Physicians• Hong Kong Dietitians Association• Hong Kong Doctors Union• Hong Kong Housing Authority• Hong Kong Kidney Foundation Limited• Hong Kong Nutrition Association Limited• Hong Kong Society of Nephrology• Hospital Authority• Leisure and Cultural Services Department• Physical Fitness Association of Hong Kong, China• The Association of Licentiates of Medical Council of Hong

Kong• The Chinese University of Hong Kong, Faculty of Medicine• The Chinese University of Hong Kong, the Jockey Club School

of Public Health and Primary Care• The Federation of Medical Societies of Hong Kong• The Hong Kong Academy of Nursing Limited• The Hong Kong Medical Association• The Hong Kong Private Hospitals Association• The University of Hong Kong, Li Ka Shing Faculty of Medicine• The University of Hong Kong, School of Public Health

Healthy Cities Project• Building Healthy Kowloon City Association Limited• Central and Western District Council Steering Committee on

Healthy City in the Central & Western District• Food & Environmental Hygiene Committee of Wanchai District

Council• Islands District Council Tourism, Agriculture, Fisheries and

Environmental Hygiene Committee, Islands Healthy City Working Group

• Kwai Tsing Safe Community and Healthy City Association• Kwun Tong Healthy City Steering Committee• Sai Kung District Council Social Services & Healthy and Safe

City Committee• Sham Shui Po District Council Working Group on Healthy &

Safe Community• Southern District Healthy and Safe Association Limited• Tai Po Safe and Healthy City• Tsuen Wan Safe and Healthy Community Steering Committee• Tuen Mun Healthy City Association Limited• Tung Chung Safe and Healthy City• Working Group on Promotion of Civic Education and Eastern

Healthy City under Culture, Leisure, Community Building and Services Committee of Eastern District Council

• Wong Tai Sin District Healthy & Safe City• Yau Tsim Mong Healthy City Executive Committee• Yuen Long District Healthy City Association Limited

Supporting organisations(Listed in alphabetical order)

31

World Health Day�7 April 2016� �Let’s beat diabetesWorld Health Day 2016DiabetesComplications of diabetesGlobal situationLocal situation投影片編號 7Impact of healthcare servicesImpact of healthcare servicesGestational diabetesChildhood diabetesLocal situationOverweight and obesity in adultsCentral obesityOverweight and obesityOverweight and obesityEating habit�Soft drinks or sugary beverages投影片編號 18Physical inactivityLet’s beat diabetesLet’s beat diabetesRisk factors of diabetesRisk factors of diabetesDo you have central obesityWorld Health Day�Publicity campaign World Health Day �Health education materialsWorld Health Day�Health education materialsWorld Health Day�Health education materials“Ten-minute Exercise”Key partnersSupporting organisations