From left: Prof Andrea Luk, a programme participant, Prof Juliana Chan, Dr Juliana LuiA programme targeting 9,000 adults 18–44 years of age will identify individuals with high 10-year risk of diabetes through DNA testing and provide precision preventive intervention.
The Jockey Club Precision Prevention Programme on Young Onset Diabetes, spearheaded by the Hong Kong Institute of Diabetes and Obesity (HKIDO) at the Chinese University of Hong Kong (CUHK) in collaboration with the Asia Diabetes Foundation, St James’ Settlement, and a network of community healthcare professionals, is a 4-year programme that will recruit 8,000 participants through community outreach and 1,000 participants through referral by physicians.
The programme comprises a 2-year screening phase, which commenced in November 2024, and a 2-year individualized intervention phase, during which participants will receive risk-tailored interventions aimed at preventing or delaying diabetes onset and reducing the risk of diabetes complications.
Eligible participants are those 18–44 years of age normally residing in Hong Kong, who have no history of diabetes and ≥1 risk factor, including overweight or central obesity; family history of diabetes; smoking history; history of hypertension, hyperglycaemia, abnormal lipid profile, cardiovascular disease, or fatty liver; history of gestational diabetes, polycystic ovary syndrome (PCOS), or delivery of an infant ≥4 kg; and <150 minutes of exercise weekly.
“Our programme complements the government’s Chronic Disease Co-Care Pilot Scheme, which targets individuals ≥45 years of age,” said Professor Juliana Chan, Director of HKIDO, CUHK.
2-tier screening, individualized 2-year intervention
Participants will first undergo saliva-based DNA testing for 254 genetic markers, a finger-prick test, and a questionnaire assessment. Those with high 10-year risk (ie, ≥50 percent risk) of diabetes will undergo oral glucose tolerance test (OGTT) for screening of prediabetes or diabetes.
“Over the last three decades, we have discovered and validated hundreds of Asian-specific genetic markers for diabetes. By combining these genetic markers with other modifiable and nonmodifiable risk factors, we have developed sequencing tests and algorithms to identify genetically predisposed individuals for early intervention,” said Chan.
High-risk participants will receive individualized interventions for 2 years, including physician consultations (4–6 per year), antihyperglycaemic / antihypertensive / lipid-lowering therapy as indicated, continuous glucose monitoring (CGM), OGTT monitoring, cardiovascular-kidney-metabolic risk assessment, a body fat weighing scale, and digital health support.
Participants with prediabetes or diabetes will be provided with CGM, C-peptide assessment, and health workshops. Those with diabetes will additionally be assessed for insulin autoantibodies and diabetes complications. Smokers will be referred to smoking cessation programmes.
For all participants, monthly health webinars will be provided during the intervention phase.
Initial results: Diabetes in 8.5 percent of OGTT recipients
As of 23 October 2025, 5,444 participants had been recruited. Data from 4,112 participants (mean age, 36 years; female, 71 percent) analyzed thus far showed diabetes family history in 49 percent, overweight or central obesity in 57 percent, fatty liver in 12 percent, and current or former smoking in 7 percent. Of note, 87 percent lacked regular exercise. About 10 percent of female participants had a history of gestational diabetes or PCOS.
Among 3,328 participants with DNA testing results available, 45 percent were of high risk. Fifty-two percent of high-risk individuals underwent OGTT, and blood and urine tests. “Diabetes was detected in 8.5 percent of these individuals, while 47 percent had high 1-hour or 2-hour plasma glucose post-OGTT,” reported Chan.