World Diabetes Day is celebrated every year on November 14th. In the past, diabetes is commonly thought of as a chronic illness for middle-aged and elderly people. In fact, overweight children are also susceptible to type 2 diabetes. Dr Lam Tung, a general practitioner, and Dr Wong Cheuk Lik, a specialist in endocrinology, diabetes and metabolism, are here to explain detailed information about diabetes to help parents understand more about the disease and prevent it in their children.

1 in every 10 Hongkongers has diabetes

Recent statistics have shown that with changes in living environments, daily routines and dietary habits, the risk of diabetes is no longer limited to middle-aged and elderly individuals. Currently, there are about 700,000 diabetic patients in Hong Kong, accounting for 10% of the total population. Therefore, diabetes is now a disease that requires attention from the general public. Although diabetes cannot be cured, establishing good lifestyle and dietary habits can help control the condition and enable patients to lead a quality life.

General practitioner Dr Lam Tung pointed out that due to the trend of late marriage, many couples only plan to have one or two children. Parents also tend to spoil their children and often use food or drinks as rewards, which often contain high sugar and fat. Coupled with insufficient exercise among children, this makes childhood obesity a global phenomenon.

Overweight children are at 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.

Childhood obesity can lead to numerous troubles in the future

Dr Lam added that if overweight children do not revise their lifestyle habits, they are likely to remain overweight when they grow up, and obese adults often develop higher 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.

Dr Wong Cheuk Lik, a specialist in endocrinology, diabetes and metabolism, said, “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.”

Dr Wong also suggested building a fitness routine. He said, "Exercise can increase muscle insulin sensitivity. Regular exercise can also increase muscle mass, improve basal metabolic rate, and make it easier to burn calories, which helps prevent obesity. In the long run, exercise can also improve cardiopulmonary function, reduce the risk of cardiovascular disease and its mortality rate."

Dr Wong suggests these 4 dietary changes:

Adopt a Mediterranean diet

In terms of dietary habits, it is essential to maintain a balanced and healthy diet. 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, can help prevent diabetes, lower cholesterol levels, and prevent cardiovascular diseases. It is also recommended to use vegetable oils like olive oil.

Meal sequencing for blood sugar control

Eating vegetables and meat before eating carbohydrates can slow down absorption and thus reduce the speed of blood sugar spikes. When eating carbohydrates, it is recommended not to consume large amounts at once, but to evenly distribute them throughout the day to slow down the speed of blood sugar spikes. 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. Since everyone's nutritional needs are different, you may consult a dietitian to determine the appropriate portion sizes.

Eat fruits with their skin on to slow down blood sugar spikes

Some fruits can be washed and eaten with the skin, as dietary fibre can slow down the speed of blood sugar spikes. In addition, dairy products also contain carbohydrates. Drinking too much at once or adding too much milk to tea and coffee can also affect blood sugar levels.

Avoid excessive absorption of hidden carbohydrates

Root vegetables such as potatoes, pumpkins, sweet potatoes, lotus roots and kudzu roots often are overlooked sources of carbohydrates. These vegetables are often used to make soups, and even if the solids are not consumed, the carbohydrates will dissolve into the soup and cause blood sugar spikes.