Jockey Club Precision Prevention Programme on Young Onset Diabetes

Summary

This is a community-based implementation program consisting of multiple components delivered by a multidisciplinary team to detect and prevent young onset diabetes with precision and value using biogenetic markers, digital tools, integrated care through public private partnership. Adults aged between 18 and 44 (inclusive) without known diabetes and with at least one risk factor for diabetes will undergo a saliva DNA and capillary blood test and complete a questionnaire. Depending on their risk levels, participants will be stratified to high risk and low risk progressors to diabetes. The high risk progressors will undergo annual oral glucose tolerance test to detect diabetes and impaired glucose tolerance (IGT). All participants will receive a personalized report indicating their genetic and modifiable risk explained by nurses or doctors. All participants will be offered regular access to webinars for education and empowerment for 2 years. The high risk group will additionally receive a 2-year risk-stratified intervention with different combinations of care interventions. These include clinical and laboratory assessment for comprehensive evaluation of cardiovascular-kidney-metabolic risks, medical and nurse consultations, empowerment by health messages, webinars, face-to-face workshops, subsidies for medications and self-monitoring tools (e.g. CGM devices, weighing scale) to motivate behavioural change. The outcomes will be analysed within the REAIM framework (reach, effectiveness, adoption, implementation and maintenance), progresssion to prediabetes or diabetes, patient reported outcomes and cost effectiveness.

Conditions

• Diabetes
• Pre Diabetes
• Hypertension
• Dyslipidemia
• Obesity

Interventions

DRUG

Medication

Nurse and medical consultations and subsidized medications (metformin, statin, ARB) will be provided to the high risk progressor, IGT and diabetes groups as appropriate for control of glucose and CKM risk factors.

GENETIC

Risk assessment with biogenetic and clinical test to predict diabetes risk

All participants will undergo genetic test and clinical measurement including body weight, body height, blood pressure, waist circumference and capillary blood glucose to predict diabetes risk with report explanation by doctors (for high risk, IGT and DM) and nurses (low risk). Genetic report will be updated annually for high risk and IGT group using updated clinical factors (e.g. age, BMI, BP).

DEVICE

Continuous glucose monitoring (CGM) devices and/or weighing scale

All high risk progressors will be given subsidized weighing scale and low-intensity laboratory assessments, nurse and doctor consultation, regular WhatsApp messages and webinars for 2 years. The IGT and DM group will receive additional subsidized CGM devices for empowerment.

BEHAVIORAL

Visit to family doctor with nurse education

All participants in high risk, IGT and diabetes groups will have regular follow-up by family doctors and nurses.

DIAGNOSTIC_TEST

Joint Asia Diabetes Evaluation (JADE) assessment

Participants found to have diabetes on OGTT will undergo annual JADE assessment which include eye/foot/urine/blood tests with issue of a personalized JADE report. The JADE Program is a quality improvement program to improve self management and inform shared decision making between doctor and patient.

BEHAVIORAL

Education webinars, workshops and health messages

All participants would join the webinars. High risk progressors, IGT and DM group will receive regular WhatsApp messages, webinars and workshops.

DIAGNOSTIC_TEST

Oral glucose tolerance test (OGTT) and cardiovascular-kidney-metabolic (CKM) risk factors

High risk progressors will undergo OGTT and measurement of CKM factors at baseline. In those without IGT or diabetes, they will undergo OGTT and CKM risk factor assessment annually for 2 years. The IGT group will additionally have measurement of beta-cell function (HOMA indexes) and the DM group will additionally have autoimmune marker measurement.

Sponsors & Collaborators

• Chinese University of Hong Kong

  collaborator OTHER

• St. James' Settlement

  collaborator OTHER

• Asia Diabetes Foundation

  collaborator OTHER

• Juliana CN Chan

  lead OTHER

Principal Investigators

• Juliana CN Chan · Chinese University of Hong Kong

Study Design

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

44 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-11-23

Primary Completion

2027-10-31

Completion

2028-05-31

Countries

• Hong Kong

Study Locations