Using Data to Transform Diabetes Care and Patient Lives

Diabetes is a common chronic disease characterised by sustained high blood sugar levels, which affects more than 10% of the population in Hong Kong and more than 530 million people worldwide. In addition, abnormal blood glucose now affects approximately one out of every six pregnant women globally, thereby adversely affecting the long-term health of both mothers and their babies. For three decades, the Diabetes and Endocrine Research Group at CUHK has been at the forefront of adopting various research methods to redefine diabetes and translate knowledge into diabetes prevention and treatment strategies. Its researchers were among the first to publish the unique characteristics of Asian patients with diabetes in international journals, including the tendency for young-onset diabetes, metabolic syndrome, kidney disease and cancer. In addition to charting the development of diabetes and metabolic abnormalities across different stages of the life course, the group has also pioneered the discovery of Chinese-relevant genetic markers in diabetes and its complications, and invented the web-based Joint Asia Diabetes Evaluation (JADE®) to use proprietary technology to stratify risk of diabetes, empower patients’ self-management and promote doctor-patient communication.

In 2020, Prof Juliana Chan of CUHK’s Diabetes and Endocrine Research Group spearheaded a group of 44 global experts to spend four years reviewing, critiquing and synthesising evidence, and publishing the Lancet Commission Report on Diabetes, which identified major gaps in prevention, treatment, care and professional education in diabetes, and provided roadmap to reduce burden of diabetes and chronic diseases on our society.

This project seeks to leverage CUHK’s resources, experience and local and international partnerships to reduce these gaps through the following key strategies: (1) establishing a multi-centre Hong Kong Gestational Diabetes Register complemented by a three-year randomised trial incorporating e-care to prevent diabetes in mothers and later generations; (2) implementing a three-year clinical trial to evaluate the effects of a multi-pronged intervention programme incorporating cognitive-psychosocial-behavioural intervention to improve care and quality of life for young people with diabetes and obesity; (3) using big data to evaluate real-world clinical outcome with newer glucose-lowering agents; and (4) expanding existing professional diabetes programmes and annual conferences into a web-based educational platform as part of the Lancet Commission Report’s recommendations for sharing progress and best clinical practices of this project through our global network.

This project builds on the foundation of research, care and education pioneered by the project team over the past three decades, with the support of our long-term partners in the fields of public health, epidemiology, surgery, family medicine, psychology and behavioural science. Designated as an International Diabetes Federation (IDF) Centre of Excellence in Diabetes Care and IDF Centre for Education, our achievements have been recognised with numerous major international awards. Deliverables from this project will transform diabetes care and patients’ lives and position Hong Kong as a global centre of excellence for innovative medicine, translational research, health education and care.

Impact to the Research Field, Society and Economy and/or Quality as an Area of Excellence

• The project team will develop and evaluate a new mode of follow-up with regular assessment for women with gestational diabetes to empower individuals to adopt healthier lifestyle through regular structured evaluation, improving the health trajectory of women and their babies after pregnancies affected by gestational diabetes.
• The team will develop a scalable intervention programme incorporating e-health, smartphone messaging, group counselling, and empowerment to prevent diabetes among women with gestational diabetes, and will evaluate it in a randomised controlled trial.
• The project will develop a comprehensive programme to address the complex biomedical-psychosocial-behavioural needs of young people with diabetes and obesity in order to improve their overall health and provide a new approach to young-onset diabetes.
• The use of big data to provide comprehensive projections of the burden of different diabetes complications and co-morbidities to inform policy and service planning.
• The project will generate new data and tools for the development of biomedical technologies that can be utilised for screening and monitoring health parameters, and improving disease classification for metabolic diseases for individualised management, which will enhance the development of biotechnology in the Greater Bay Area.
• A platform will be established for delivering regular professional education to share globally the learning and experience from the CUHK-Prince of Wales Hospital (PWH) Diabetes Centre, developing a network of healthcare professionals engaged in improving diabetes care in the community.
• A training curriculum that complements the Joint Asia Diabetes Evaluation (JADE®) platform, will be devised to facilitate and empower other physician researchers in Asia or overseas to set up local diabetes registers, building on the experience of the CUHK-PWH Diabetes Centre.  This will address gaps in care and help improve diabetes care.

List of Project Team Members

Project Coordinator:
- Prof Ronald Ching-wan Ma, The Chinese University of Hong Kong

Co-Principal Investigators:
- Prof Juliana Chung-ngor Chan, The Chinese University of Hong Kong
- Prof Elaine Yee-kwan Chow, The Chinese University of Hong Kong
- Prof Alice Pik-shan Kong, The Chinese University of Hong Kong
- Prof Andrea On-yan Luk, The Chinese University of Hong Kong

Co-Investigators:

- Prof Esther Oi Wah Chow, Hong Kong Shue Yan University
- Ms Amy Fu, Asia Diabetes Foundation
- Prof Lai-ling Connie Hui, Hong Kong Polytechnic University
- Ms Vanessa Heilyn Lau, Hong Kong Institute of Diabetes and Obesity
- Ms Kitman Loo, Prince of Wales Hospital
- Prof Juliana Lui, The Chinese University of Hong Kong
- Prof Winnie Wing-Sze Mak, The Chinese University of Hong Kong
- Prof Phoenix Kit-han Mo, Jockey Club School of Public Health and Primary Care
- Dr Risa Ozaki, Prince of Wales Hospital
- Prof Wing Hung Tam, The Chinese University of Hong Kong
- Dr Kit Ying Tsoi, The Chinese University of Hong Kong
- Prof Hong jiang Wu, The Chinese University of Hong Kong
- Prof Aimin Yang, The Chinese University of Hong Kong
 

Collaborators:
- Dr Wing Cheong Leung, Kwong Wah Hospital
- Prof Leeling Lim, University of Malaya
- Dr Teresa Wei Ling Ma, Queen Elizabeth Hospital

- Dr Arthur Mak, Cambridgeshire and Peterborough NHS Foundation Trust

- Prof Calvin Ke, University of Toronto
- Dr Meliza Choi-Wah Kong, United Christian Hospital

- Dr Isabella Yi Man Wah, Prince of Wales Hospital

- Prof Chi Chiu Wang, The Chinese University of Hong Kong

- Prof Simon Kin Hung Wong, The Chinese University of Hong Kong

- Prof Xilin Yang, Tianjin Medical University

- Ms Phyllis Yau, Prince of Wales Hospital
- Prof Rose Laiwah Yeung, University of Alberta

International Advisory Board:

- Prof Edward Gregg, Imperial College

- Prof Brian Oldenburg, La Trobe University & Baker Heart and Diabetes Institute

- Prof Maria Inês Schmidt, Universidade Federal do Rio Grande do Sul

- Prof Ken Ong, University of Cambridge

- Prof Nick Wareham, University of Cambridge