Diabetes is set to soar to epidemic proportions in Hong Kong in the next century, a leading American endocrinologist warned yesterday. 'By 2010 or 2020 there may be as many as 200 million to 250 million diabetics in the Asian region,' Dr Harold Lebovitz said, adding that the burden on health care costs locally could bankrupt the government. 'In the 21st century this problem is going to be the leading medical problem in Asian health care. A large percentage of the Asian population is generally disposed to develop diabetes,' he said. Dr Lebovitz is head of endocrinology and metabolism, and director of the Clinical Research Centre at the State University of New York's Health Science Centre in Brooklyn. He said Hong Kong's rate of about eight per cent prevalence of diabetes in adults could soar to 16 to 17 per cent as the population aged. 'The number of cases will increase astronomically,' he said, arguing that Westernisation of lifestyle in Hong Kong was the main culprit. 'Most of the early symptoms of diabetes are not too severe. Chronic complications arise 10 to 20 years after you develop the disease,' he said. Diabetes occurs because of a reduction in insulin secretion or action, resulting from an interaction between genetic and environmental factors. It is one of the 10 leading causes of death in Hong Kong, killing 425 people in 1994. Of these, 187 were men and 238 women. More than 97 per cent of the victims were aged 45 or over. Long-term complications such as kidney failure, strokes and coronary disease would increase unless Hong Kong people rethought their lifestyle, Dr Lebovitz warned. 'If you were to keep thinner, you could cut back a lot. You have to stop this increase in diabetes in Asia,' he said. 'Getting into a Western lifestyle is bad for you. You are eating high-calorie foods, not walking anywhere . . . there's a lack of physical activity.' A survey carried out by Queen Mary Hospital in 1994 found that out of a random sample of 3,000 people aged between 25 and 74, the prevalence of diabetes in men was 8.9 per cent and 8.8 per cent in women. The prevalence increased with age from 1.9 per cent for those aged 25 to 34, to more than 20 per cent for those aged 65 to 74.