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Box 4.6
Defining “diabetes” and “prediabetes”
What is “diabetes mellitus”?
Diabetes mellitus (DM) is a chronic disease, which occurs when the pancreas
does not produce enough hormone insulin, or when the body cannot
effectively use the insulin it produces. This leads to an increased
concentration of glucose in the blood, clinically referred to as
hyperglycaemia. There are three major types of DM: Type 1 diabetes, Type 2
diabetes, and gestational diabetes. Type 2 diabetes is the most
prevalent form of diabetes amongst Hong Kong adults.
What is “prediabetes”?
Prediabetes is a largely asymptomatic condition in patients at risk of
progressing to a diagnosis of diabetes if the condition is not detected and
addressed in a timely manner. It is characterised by blood sugar level that is
higher than normal but not within the diabetic range, clinically
referred to as intermediate hyperglycaemia. Individuals that fall within the
prediabetic range can either have impaired fasting glucose or
impaired glucose tolerance.
In 2003, the World Health Organization (WHO) and International Diabetes Federation (IDF)
met to propose screening as a possible solution to the growing burden of DM globally, with
projections at the time showing that DM prevalence will double to 350 million people
between the years 2003 and 2030 (WHO, 2003). This estimated prevalence was surpassed
in 2014, when the global burden of DM nearly quadrupled with an estimated 422
millions adults living with DM compared to 108 millions in 1980, with the
highest DM prevalence observed in China.
As a conclusion, in 2003, the two organisations drew a case for DM screening in countries
with increasing prevalence, outlining the considerations relevant to the development of a
screening policy (Figure 4.6). In cases, such as Hong Kong’s health system, where there is
capacity to screen and where prevalence of chronic conditions is growing, there is a strong
argument towards strengthening the screening capacity of the health system.
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