Diabetes in Canada

What is diabetes?

Diabetes is a disease in which blood glucose (sugar) is above normal levels. With diabetes, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced.

Are there different types?

Type 1 develops most often in children and young adults before age 30, although it can appear at any age. There is no known cause and, thus, no way to prevent it. It is not caused by consuming too much sugar. A person who has type 1 diabetes must take insulin daily. Lifestyle changes such as healthy eating and increased physical activity are basic therapies. Blood glucose levels must be closely monitored through frequent blood glucose testing.

Type 2, previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, is the most commonly diagnosed type of diabetes accounting for about 90% of diabetes patients. With type 2 diabetes, the body can't use the insulin it makes. This condition is associated with those 40 or older, obesity, family history of diabetes, high blood pressure, abnormal cholesterol levels, schizophrenia, polycystic ovary syndrome, acanthosis nigricans (darkened patches of skin), previous history of gestational diabetes, history of giving birth to a baby more than 9 pounds, physical inactivity and ethnicity (Aboriginal, Hispanic, Asian, South Asian, or African descent); type 2 is increasingly being diagnosed in children and adolescents. Healthy eating, physical activity and blood glucose testing are basic therapies. Many require oral medication, insulin or both to control blood glucose levels.

Gestational diabetes is glucose intolerance, but with first onset during pregnancy. It only affects women during pregnancy and then usually disappears. Women at greater risk have a history of gestational diabetes, age over 35, obesity, a history of polycystic ovary syndrome, hirsutism (excessive hair growth in women), acanthosis nigricans and or may be a member of a population considered to be at high risk for diabetes. Because women with a history of gestational diabetes risk developing type 2 diabetes later in life, a follow-up blood glucose test is recommended within six months of childbirth. In addition, it is recommended that women breastfeed to reduce the risk for subsequent diabetes in the baby. Women should be screened regularly for type 2 diabetes.

How common is diabetes?

More than 2 million Canadians have diabetes, with that number expected to rise to 3 million by 2010. The World Health Organization estimated in 2000 that more than 177 million people worldwide have diabetes. By 2025, it will top 300 million. In Ontario alone, we have already surpassed the World Health Organization's prediction of a 39-per-cent increase in diabetes prevalence around the world by 2030.

Why is managing diabetes important?

About 80 per cent of people with diabetes will die as a result of heart disease or stroke and the condition is a factor in the deaths of about 41,500 Canadians each year. Canadian adults with diabetes are twice as likely to die prematurely than those without diabetes. For those with type 1 diabetes, life expectancy may be shortened by as much as 15 years. Diabetes is also costly from a financial perspective with individuals incurring medical costs that are two to three times higher than those without diabetes. A diabetic can face direct costs for medication and supplies ranging from $1,000 to $15,000 a year.

What does diabetes cost the health system?