Currently, one in ten people in Hong Kong has diabetes, with the majority being middle-aged and elderly people, but the disease is becoming more common in younger populations. Although diabetes cannot be cured, it is manageable by establishing healthy lifestyle and dietary habits. Today is World Diabetes Day, and three doctors are conducting a multidisciplinary consultation to raise public awareness of diabetes and explain the key to diabetes prevention.

Advice from the Specialist in Endocrinology, Diabetes & Metabolism

Dr Wong Cheuk Lik, a specialist in endocrinology, diabetes and metabolism, pointed out that weight control, dietary changes and exercise are essential for diabetes prevention. A large-scale study has shown that the combination of dietary changes, exercise and a 5-10% reduction in body weight is more effective than medication. Plus, there are currently medications available to help prevent diabetes, with the most common being metformin. Diabetes mainly affects middle-aged and elderly people, as insulin secretion capacity declines with age. Lack of exercise also weakens the glucose metabolism capacity of muscles, indirectly reducing insulin sensitivity. A sedentary lifestyle can lead to mid-life obesity, which can increase insulin resistance. Central obesity also causes visceral fat to release adipokines, leading to inflammation and insulin resistance.

Dr Wong suggested high-risk individuals adopt a Mediterranean diet in terms of dietary adjustment. Clinical studies have found that a Mediterranean diet, which emphasizes plant-based foods such as vegetables, legumes, nuts, seeds, fruits and grains, as well as fish, seafood and dairy products, and the use of vegetable oils like olive oil, can help prevent diabetes, lower cholesterol levels and prevent cardiovascular diseases.

Other dietary patterns include a vegetarian diet, a low-fat diet where fat accounts for less than 30% of total daily calorie intake, and a low-carbohydrate diet where carbohydrates account for less than 30-40% of total daily calorie intake. It is also recommended to choose foods with a low glycaemic index and eat fewer ultra-processed foods. These dietary changes can help reduce blood sugar spikes and prevent obesity. In addition, it is a good idea to eat vegetables and meat before eating carbohydrates, as this can slow down absorption and thus reduce the speed of blood sugar spikes. It is also recommended not to consume large amounts of carbohydrates at once, but to evenly distribute them throughout the day. Generally, you can allocate about 40 grams of carbohydrates for breakfast, and 50-60 grams for lunch or dinner, with a small amount of snacks in between. It is best to exercise regularly as well to increase insulin sensitivity for better prevention effects.

Advice for Children from the General Practitioner

General practitioner Dr Lam Tung explains that childhood obesity can increase the risk of developing type 2 diabetes, which can cause elevated blood sugar levels, high blood lipid levels, high blood pressure, joint pain, breathing difficulties, and even non-alcoholic fatty liver disease - all of which are common complications of childhood obesity.

It is believed that childhood obesity increases the risk of developing diabetes in adulthood. Why? Dr Lam explained that if obese children do not revise their lifestyle habits, they are likely to remain obese in adulthood, and obese adults often develop insulin resistance. This makes insulin unable to control blood sugar levels properly, leading to a higher risk of developing type 2 diabetes. This is why childhood obesity can lead to the development of diabetes in adulthood.

Advice from the Cardiologist

Why is diabetes related to heart disease? Cardiologist Dr Fu Chiu Lai explained, “Statistics showed that more than 30% of diabetic patients die from cardiovascular disease. In addition, many complications of diabetes, such as diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy, are all closely related to vascular disease caused by diabetes.”

What should diabetic patients do when they have heart problems? Dr Fu stated that the first step is to maintain a positive attitude and actively combat the illness. She added, “Patients should follow their doctor’s instruction to take the right dose of medication at the right time and schedule regular appointments and examinations to prevent acute illnesses. They should also avoid unhealthy diets, avoid sitting for long periods, and engage in regular physical activity as instructed by their doctors. Be sure to maintain a work-life balance, pay attention to their health all the time, and seek immediate medical attention if any symptoms develop suddenly.”