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Patsy Moy

People are getting diabetes at a younger age and their condition is more severe and complex than 15 years ago, according to a medical professor.

Juliana Chan Chung-ngor,  an associate professor at the department of medicine and therapeutics at Chinese University, said the mean age of the disease's onset is 59 - down from 65 in 1990 - but up to 40 per cent of patients are under the age of 40.

Diabetes is generally classified into type I and type II. Type I is caused by an auto-immune disorder, where the pancreas fails to secrete insulin to allow the body to use sugar from food as energy. Type II is strongly linked to obesity, where the body uses excess fat instead of sugar as an energy source.

Both types leave patients with high glucose levels, leading to obstructions of the bloodstream that can damage major organs, including the brain, heart and kidneys.

Dr Chan said the distinction between the two types was becoming blurred and she was seeing more patients with type II characteristics who also had a predisposition towards type I diabetes.

'We found that those patients did not produce enough insulin secretion in the first place - which you may say is the common presentation of type I diabetes.

'With the very slow onset of type II, the patients of this category are not aware of their underlying problem until they will eventually come down with symptoms such as blindness and kidney failure after about 10 years.

'Obesity has aggravated and sped up the disease's onset, so it is not that clear cut whether those patients are type I or type II ... However, I would say that obesity plays a strong role in triggering the disease's onset.'

Dr Chan estimated that about 20 per cent of middle-aged patients belonged to this hybrid category and they placed doctors in a dilemma because they needed insulin injections, which in turn helped store energy in their bodies and caused them to gain weight.

'While patients are having insulin injections, we also need to teach them how to control their weight.

'We need to make them [young type I patients] understand that insulin injections are needed in their cases or there is a high risk that they may suddenly collapse and even fall into a coma.

'The management of diabetes is a big challenge. Patients can no longer fully rely on their doctors to fix their problems. Instead, our role is to assist them to manage the disease and realise that their health is, in fact, in their own hands.'



Young are increasingly at risk as obesity levels continue to rise