HONG KONG — While mortality rates for a number of diseases have dropped sharply among diabetics in recent years, those rates have remained stubbornly static for pneumonia, new research shows, a key concern given the deadly coronavirus’ links to the lung condition.

The study, conducted by experts from the Chinese University of Hong Kong and the University of Edinburgh, was put into the spotlight this week by the revelation that the city’s first recorded coronavirus death – a 39-year-old man who died on Feb 4 – suffered from diabetes.

Only days later, the epidemic’s first fatality in Guangdong province was also revealed to be a long-time diabetes patient.

Published in the European medical journal Diabetologia last month, the new study analysed Hong Kong public hospital data of 770,078 diabetic patients aged 20 or above across a 15-year period from 2001 to 2016.

Of the 185,082 deaths recorded in the period, mortality rates for all causes of death among men and women with diabetes dropped 52.3 and 53.5 per cent respectively, something researchers attributed to improved medical care and higher awareness of the disease.

According to the Department of Health, the crude death rates for diabetes were 7.2 men and 6.4 women per 100,000 people in 2015. It was the tenth most common cause of death in Hong Kong, accounting for 1.1 per cent of all deaths in 2015.

Worryingly, the mortality rate among the city’s younger diabetics compared to those without the disease held fast over the study’s length, even as those figures dipped significantly among the elderly, sparking calls from experts for early check-ups and treatment.

Diabetes increases the risk of blood vessel damage that can lead to stroke, heart disease, kidney failure and failure of other organs.

But while mortality rates for cardiovascular disease and cancer have declined by 72.2 and 65.1 per cent respectively in men with diabetes, and 78.5 and 59.6 per cent respectively in women with diabetes, pneumonia mortality rates for both sexes have remained largely stable at 3-4 per 1,000 patients a year.

Professor Juliana Chan Chung-ngor, a CUHK researcher involved in the study, said falling mortality rates for cardiovascular illnesses among diabetics could be explained by better medical diagnosis, treatment and technology, but a patient could be particularly at risk of pneumonia and other respiratory diseases due to a weak immune system, which was a bigger challenge for doctors.

“For many patients with diabetes, especially the elderly, their body is very frail. So like an old car, no matter how well you maintain it, those patients tend to do poorly during flu seasons and when exposed to acute emergencies due to new viruses and bacteria,” she explained.

“So the last medical event for them is usually respiratory viral or bacterial infection, and that becomes their leading or immediate cause of death.”

Prof Chan said the study also showed a worrying trend in which mortality rates for diabetes patients between 20 and 44 years of age held steady at eight times higher than their same-aged peers without diabetes over the period, while the figures for diabetes patients aged above 75 dropped from 3 to 1.5 times higher than their same-aged peers without diabetes.

Part of that disparity is driven by ignorance among younger Hongkongers as to their susceptibility to the disease.

“People tend to think that only older people were more likely to die from diabetes, but nowadays young people have a gap in their understanding of the disease, and don’t think they would have it at the age of 30,” Prof Chan said.

“Therefore they may have missed medical appointments, delayed check-ups and failed to take prescriptions on time.”

She explained that young people, whether lean or obese, could end up with the illness due to a family history of diabetes or unhealthy lifestyles that feature poor diets, heavy drinking, or sleeping badly.

The academic called on locals, especially the young, to go get checked for diabetes, especially when the illness could also have a greater impact on young people’s health, due to a longer disease duration over the rest of their lives. SOUTH CHINA MORNING POST