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Figure 4.6
Considerations for screening policy development

TO SCREEN NOT TO SCREEN

Clear evidence that screening is Clear evidence that screening is
harmful
beneficial
Epidemiological consideration High prevalence or undiagnosed Low prevalence or undiagnosed
type 2 diabetes
type 2 diabetes
High prevalence or cardiovascular
Low prevalence amongst people
with type 2 diabetes
disease (CVD) risk and other
complications amongst people
with type 2 diabetes Low capacity of health care system
High capacity of health care
Considerations of health system capacity system for effective clinical system for effective clinical
for screening
system for screening
Low capacity of the health care
High capacity of the health care
management of those who
management of those who screen
screen positive
positive
High capacity of the health care
Low capacity of the health care
system for supporting the
system for supporting the
psycho-social effects of screening
psycho-social effects of screening
High capacity of the health care
Low capacity of the health care
system to implement these
system to implement prevention
strategies in individuals at high risk
prevention strategies
of the future development of
negative on that occasion
Low cost of early detection
Economic considerations diabetes even those who screen High cost of early detection
High cost of clinical management
Low cost of clinical management

Note: Figure is adopted from (WHO, 2003)
Source: WHO, 2003
Of note, diagnostic criteria for DM varies globally due to variances in epidemiology and
demographic trends of health systems. Such diagnostic differences can impact the case
definitions of DM and the health system’s recognition of the severity of disease (Appendix J).
This analysis follows diagnostic criteria guidelines as stipulated in the latest Hong Kong
Reference Framework for Diabetes Care for Adults in Primary Care Settings (Appendix K).

4.3.2 DIABETES AND CARE EVALUATION IN HONG KONG

Hong Kong has observed a large impact from disease complications and economic
costs to the city’s public healthcare system due to the rising prevalence of DM (HealthyHK,
2021). To understand whether there is scope for targeted DM screening and
possible expansion of screening services to a larger proportion of the
population, we first assess the i) disease burden; and ii) economic burden of DM in
Hong Kong.

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