Objective: Over two thirds of the world’s population with diabetes reside in Asia but data on time trends of diabetes incidence in this region is limited. Using population-wide data, we report trends in the incidence of type 1 and type 2 diabetes (T2D) in Hong Kong over a 14-year period.
Methods: The Hong Kong Diabetes Surveillance Database (HKDSD) hosts clinical information of people with diabetes under the care of the Hong Kong Hospital Authority, a statutory body governing all public hospitals and out-patient clinics locally. Diabetes type was determined using a validated algorithm that considers both encounter codes and prescription data. Gender-specific incidence rates (per 100,000 person-year) separated by age categories were standardized to age structure of the World Health Organization population. Average annual percentage change (AAPC) was calculated using joinpoint regression analysis to describe incidence trends over time.
Results: The HKDSD included 2426 cases of type 1 diabetes (T1D) and 535490 cases of T2D newly detected between 2002-2015. Among youth (age<20 years), incidence of both T1D and T2D increased linearly (T1D: 4.6 to 6.4 [AAPC 4.7%] in girls, 2.8 to 5.3 [AAPC 3.6%] in boys; T2D: 4.1 to 8.5 [AAPC 4.2%] in girls, 2.6 to 7.5 [AAPC 5.4%] in boys). In young adults (age 20-<40 years), incidence of T1D remained stable but incidence of T2D increased over time (48.1 to 62.1 [AAPC 3.3%] in women, 77.6 to 110.8 per 100,000 person-year [AAPC 4.2%] in men). In older adults (age ≥40 years), incidence of T2D increased between 2005-2011 but stabilized thereafter, whereas incidence of T1D was unchanged.
Conclusions: We observed an increase in incidence of T2D in youth and young adults and stabilization in older adults. Incidence of T1D continued to climb in youth but remained constant in adults. This study highlights the emerging problem of young-onset diabetes and calls for effective strategy for diabetes prevention in young people.
A. Luk: None. C. Ke: None. E.S. Lau: None. R.C. Ma: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Research Support; Self; AstraZeneca, Bayer AG, Pfizer Inc. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; AstraZeneca. E. Chow: Research Support; Self; Powder Pharmaceuticals Inc., Sanofi-Aventis. A.P. Kong: Advisory Panel; Self; Lilly Diabetes. Research Support; Self; AstraZeneca, Lilly Diabetes. Speaker's Bureau; Self; Abbott. Other Relationship; Self; AstraZeneca, Novartis Pharmaceuticals Corporation, Sanofi. J.C. Chan: Board Member; Self; Asia Diabetes Foundation. Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Medtronic, Merck Sharp & Dohme Corp., Sanofi-Aventis. Research Support; Self; Amgen Inc., AstraZeneca, Lee Powder, Lilly Diabetes, Pfizer Inc., Sanofi-Aventis. Speaker's Bureau; Self; Ascensia Diabetes Care. Stock/Shareholder; Self; GemVCare. W. So: None.