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Diabetes in Canada

HIGHLIGHTS

Prevalence

  • Current national survey data indicate that 1.2 to 1.4 million Canadians aged 12 and over may have diabetes, although only about 800,000 of these are diagnosed cases.
  • The prevalence of diabetes increases with age: 3% of people aged 35 to 64 and 10% of those aged 65 and over have this diagnosis.
  • The age-standardized prevalence of diabetes among Aboriginal peoples is approximately triple the rate found in the general population. The age-standardized prevalence rate of diagnosed diabetes among Aboriginal peoples aged 15 and over is 10% and among those over 65 years of age it is 22.8%.

Incidence

  • Diabetes is diagnosed in an estimated 60,000 Canadians every year.

Disability and Work Loss

  • Diabetes is associated with more frequent disability days and increased loss of productivity. Among the working age population (35 to 64 years), 23% of people with diabetes had one or more disability days in a two-week period, compared with only 11% of those without diabetes. Note that disability days are not diabetes-specific.

Health Care Utilization

  • The current (1995) age-standardized rates (standardized to 1991 Canadian population) for diabetes are 112 hospital separations and 1,368 hospital days per 100,000 per year (crude rates for 1995: 115 hospital separations and 1,427 hospital days per 100,000 per year).
  • In the age group 65 and above, 24% of people with diabetes reported at least one overnight stay in a hospital, nursing home or convalescent home during the previous 12 months compared with 14% of those without diabetes.
  • Home care use in the previous one-year period is nearly twice as high among people aged 65 and older who have diabetes (16%) as among those without diabetes (9%).

Mortality

  • There were 5,447 deaths in 1996 for which diabetes was certified as the underlying cause. This ranks diabetes as the seventh leading cause of death in Canada. However, the actual number of deaths for which diabetes was a contributing factor is probably five times this number.
  • Age-standardized annual mortality rates (standardized to 1991 Canadian population) for diabetes have increased since the early 1980s, with the current (1996) rate at 16.8 per 100,000 population.
  • Approximately 25,000 Potential Years of Life Lost (PYLL) were lost as a result of diabetes prior to age 75 in 1996, representing an age-standardized rate of 85 per 100,000 population. Since 1983 there has been an increase in the age-standardized PYLL due to diabetes.
  • Projections in diabetes mortality trends into the year 2016 show an exponential increase in the number of deaths due to diabetes among males and a more linear increase among females.

Economic Burden

  • The economic burden of diabetes and its complications in Canada is estimated to be up to $9 billion (US) annually in direct health care costs and indirect costs, including lost productivity due to diabetes-related illness and premature death.

Obesity: A Modifiable Risk Factor for Diabetes

  • The majority of people (59%) with diabetes aged 35 to 64 are overweight.

Long-Term Complications

  • In the 35 to 64 age group, people with diabetes have six times the risk of heart disease or stroke as do people without diabetes; in the 65 and over age group they have twice the risk.
  • Among people over 65 years of age there is a significantly higher prevalence of permanent vision loss, cataracts, and glaucoma among those with diabetes than those without.
  • The percentage of new cases of kidney failure due to diabetes increased from 16% in 1981 to 28% in 1996; 3,340 people with diabetes were receiving treatment for kidney failure as of December, 1996.

Prevention Opportunities

  • Research is needed into the prevention and treatment of obesity and physical inactivity, the two most important modifiable risk factors for Type 2 diabetes.
  • Tight control of blood sugar levels can significantly decrease rates of microvascular complications (eye disease and kidney disease). Macrovascular complications (such as heart disease and stroke) can be significantly decreased in Type 2 diabetes through effective blood sugar and blood pressure control.
  • More funding support is needed into the causes of Type 1 diabetes (usually with onset in those under age 40) in search of a cure.

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