title: Diabetes incidence and prevalence in Hong Kong, China during 2006-2014.
abstract: To estimate recent secular changes in the incidence and prevalence of diabetes and pre-diabetes among Hong Kong Chinese adults, and thus show possible future trends for developing mainland China.
  
  
  
  Based on a complete census of the public sector health records of 6.4 million people from 2006 to 2014, diabetes cases were ascertained using different methods including the World Health Organization (WHO) 2011 guidelines (HbA1c, fasting plasma glucose and glucose tolerance test), American Diabetes Association (ADA) 2015 guidelines (plus random plasma glucose), and additionally recorded diagnosis codes and medication dispensation. Pre-diabetes was defined using ADA 2015 guidelines.
  
  
  
  We identified 697 201 people with diabetes (54.2% were incident cases); and 1 229 731 people with diabetes or pre-diabetes. In 2014, the overall incidence of diabetes was 9.46 per 1000 person-years [95% confidence interval (CI): 9.38 to 9.54], and overall prevalence was 10.29% (95% CI: 10.27% to 10.32%). Incidence of diabetes decreased significantly from 2007 to 2014 (quadratic trend, P < 0.001). From 2006 to 2014, the prevalence of diabetes increased significantly in both sexes and across all age groups (quadratic trend, P < 0.001). The overall incidence of pre-diabetes in 2014 was 18.88 per 1000 person-years (95% CI: 18.76 to 18.99), and the overall prevalence of pre-diabetes was 8.90% (95% CI: 8.87% to 8.92%).
  
  
  
  Similar to other developed western and Asian populations, diabetes (and pre-diabetes) incidence in Hong Kong Chinese appeared to have stabilized and there have been small declines during the period of observation. Ageing and survivorship will likely drive a continued increase in the prevalence of diabetes and pre-diabetes, albeit with a decelerating growth rate if past trends persist.
authors.affiliation: Division of Health Economics, Policy and Management, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: J
authors.identifier: 0000-0002-8386-8512
authors.initials: J
authors.lastname: Quan
authors.affiliation: Division of Health Economics, Policy and Management, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: T K
authors.initials: TK
authors.lastname: Li
authors.affiliation: Division of Health Economics, Policy and Management, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: H
authors.initials: H
authors.lastname: Pang
authors.affiliation: Queen Elizabeth Hospital, Hong Kong.
authors.forename: C H
authors.initials: CH
authors.lastname: Choi
authors.affiliation: Department of Medicine & Rehabilitation, Tung Wah Eastern Hospital, Hong Kong.
authors.forename: S C
authors.initials: SC
authors.lastname: Siu
authors.affiliation: Tuen Mun Hospital, Hong Kong.
authors.forename: S Y
authors.initials: SY
authors.lastname: Tang
authors.affiliation: Kwong Wah Hospital, Hong Kong.
authors.forename: N M S
authors.initials: NMS
authors.lastname: Wat
authors.affiliation: Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: J
authors.initials: J
authors.lastname: Woo
authors.affiliation: Division of Health Economics, Policy and Management, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: J M
authors.initials: JM
authors.lastname: Johnston
authors.affiliation: Division of Health Economics, Policy and Management, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: G M
authors.initials: GM
authors.lastname: Leung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D019049:Developed Countries; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology; D057286:Electronic Health Records; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006306:Health Surveys; D019456:Health Transition; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D012306:Risk; D013222:State Medicine; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human