A Sharing by Alumnus Dr Chris Chan on Diabetes from Chinese Medicine Perspective
Alumnus Dr Chris Chan (Chinese Medicine) graduated from Hong Kong Baptist University with the Bachelor of Chinese Medicine and Bachelor of Science in Biomedical Science, and subsequently completed MSc in Public Health at the University of London, MD (Chinese Medicine) at Guangzhou University of Chinese Medicine and PhD in Medicine at the University of Hong Kong. He has worked for the Hospital Authority of Hong Kong, World Health Organization, Tung Wah Group of Hospitals, KPMG Advisory, and has also sat on various charities and government committees to promote the development of Chinese Medicine.
Presently, he joins the academia working as a clinical researcher in evidence-based integrative medicine at The University of Hong Kong/Queen Mary Hospital. His clinical practice and research shows that add-on Chinese Medicine has a significant positive effect on the preservation of kidney function among diabetic patients, and it also can significantly reduce the mortality rate of COVID-19 patients.
| 1. |
How common is diabetes in Hong Kong? Please list three key risk factors for diabetes. |
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From the latest report of the Population Health Survey conducted between 2014-2015, 8.4% of the total Hong Kong population is estimated to have suffered from diabetes. Among them, 54.1% are undiagnosed.
Common symptoms include frequent thirst, frequent urination, frequent hunger, weight loss, fatigue, blurred vision, poor wound healing and itching skin. Nevertheless, these symptoms often are non-specific and diabetes in the early stage could be asymptomatic.
Key risk factors of diabetes include physical inactivity, aging, unhealthy diet, obesity, high blood pressure and family history. A large-scale study with 271,174 subjects published in 2018 shows that smoking is the strongest predictor of death among type 2 diabetes patients. |
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| 2. |
What is the cause of diabetes from the Chinese Medicine perspective? How does it compare with that from Western Medicine perspective? |
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From the classics of Chinese Medicine, the presentation of diabetes is similar to Xiao-ke (消渴) and is one of the diseases developed among the obese population (膏人). The key pathophysiology involves congenital and environmental risk factors including stress, unhealthy diet, physical inactivity and obesity, all of which could cause accumulated heat and qi deficiency (氣虛).
In Western Medicine, diabetes involves beta-cell dysfunction, insulin resistance and gut microbiome dysbiosis, all of which could cause the glucose homeostasis imbalance, and induces oxidative stress and inflammation via multiple immunometabolic and signaling pathways.
The understanding of diabetes from Chinese Medicine and Western Medicine perspectives sounds different but indeed they are simply analysing diabetes from different perspectives: Chinese Medicine focuses on the epidemiological factors while Western Medicine puts emphasis on the molecular level. These understandings nowadays are increasingly crossing over with each other. |
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What treatment does Chinese Medicine provide for diabetes? How does Chinese Medicine work with Western Medicine? |
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Chinese Medicine diagnoses and manages patients based on their symptoms. From our latest research, add-on symptom-based diagnosis improves the predictive power on kidney function decline among diabetic patients based on key biochemical and epidemiological factors. Presentation of edema, alternating dry and loose stool, epigastric bloating, thin tongue, deep pulse and unsmooth pulse are all associated with faster kidney function decline.
Chinese Medicine clinicians consider the pathogenesis from patients’ symptoms to personalise the prescription. For instance, if a patient shows predominantly symptoms that are associated with heat (e.g. dry mouth, frequent thirsty, red tongue, etc.), Chinese Medicines that clears heat (e.g. 桑葉, 枇杷葉) would be used. Whereas if a patient shows symptoms that are associated with weakened kidney, kidney-strengthening Chinese Medicines (e.g. 桑寄生, 地黃) would be used. Clinically patients are heterogenous, but we found that most diabetic patients in HK are either having qi-yin deficiency (氣陰兩虛) or dampness-heat.
Based on previous expert consensus and a pilot service programme, we started a service trial seven years ago aiming to evaluate the effect of Chinese Medicine on diabetic kidney disease. Our preliminary result shows that the service trial of using add-on rehmannia complex- (六味地黃丸) based Chinese Medicine prescription for 48 weeks helps the patients concerned better preserve their kidney function. An equally important observation is that fewer patients require increment in anti-diabetic drugs and there is a substantially lower risk of hypoglycemia, a common adverse side effect of concern, after taking Chinese Medicine. |
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Please provide three tips on preventing diabetes. |
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Healthy diet - low fat, low sugar, low sodium and high-fiber. |
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Physical exercise - exercise for at least 30 minutes for at least 5 days weekly. |
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Maintain a healthy body weight – normal range of body mass index (BMI) of Asians is 18.5 to 22.9.
BMI is a value derived from the mass (weight) and height of a person. The BMI is defined as the body mass divided by the square of the body height, and is expressed in units of kg/m2, resulting from mass in kilograms and height in metres. |
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| Alumnus Dr Chris Chan |
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| Apart from his profession, alumnus Chan is active in piano, Chinese music and photography with frequent performances and exhibitions, reflecting that he is an academic with multiple talents. |
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