There are special days on the calendar designed to focus attention on heart disease, strokes and cancer. Today belongs to diabetes, which, like other diseases, is influenced by lifestyle factors, such as diet and exercise. Diabetes also raises the risk of heart and kidney disease and stroke, and has been included with other non-communicable illnesses among the major health challenges for older people. World Diabetes Day marks the birthday of Frederick Banting who, with Charles Best, first conceived of the idea that led to the discovery of insulin in 1922. Though it is not infectious, diabetes can spread easily in ageing consumer societies like Hong Kong's and also tends to follow rising prosperity in developing economies. Indeed, it has long been a concern that lifestyle diseases associated with increasing affluence have rapidly changed China's national health profile. A survey of nearly 100,000 Chinese, conducted as part of research published in the journal of the American Medical Association, suggested that the incidence of diabetes among adults is rising because of affluence, particularly among the young and middle-aged. In Hong Kong, the incidence of diabetes rose to 10 per cent in the 1990s before settling back a little as people became more educated and health-conscious in their diet and lifestyles, though it is now estimated to be 10 per cent again. The risk can be reduced by a lifestyle that includes exercise, healthy eating and moderate consumption of alcohol, and excludes smoking. Education is the main community health tool available to mainland authorities. Discussion of diabetes raises the issue of obesity, a risk factor for a range of diseases. A strategy to contain diabetes must include effective education about the importance of eating wisely and exercising more. The theme of World Diabetes Day for the last five years has been education and prevention. It is hard to think of a better one for the next five.
