Diabetes

There are three main types of diabetes; the most common is type 2 diabetes which tends to occur later in life, although it can be seen in younger people. In this type of diabetes, the pancreas does not produce enough insulin and the body does not properly use the insulin which is produced. Type 1 diabetes, on the other hand, is an autoimmune disease in which the body’s immune system attacks and destroys the insulin-producing cells of the pancreas. Individuals with type 1 diabetes are dependent on an external source of insulin for life – the disease is usually diagnosed in children and youth. The third type, gestational diabetes, occurs when hyperglycaemia originates during pregnancy and usually ends after the pregnancy. Women who experience this type of diabetes are at greater risk of developing type 2 diabetes in five to ten years.

Funded Projects

Public Health Agency of Canada projects

Diabetes Funded Programs at the Public Health Agency of Canada:

Nutrition, Metabolism and Diabetes Institute (Canadian Institutes of Health Research)

 

Facts and Figures

According to Diabetes in Canada: Facts and figures from a public health perspective, 2011:

Incidence and prevalence

  • Almost 2.4 million Canadians aged one year and older (6.8% of the population) were living with diagnosed diabetes in 2008/09, and more than 200,000 Canadians were newly diagnosed (6.3 cases per 1,000 individuals) during the same year.
  • Of the Canadians diagnosed with diabetes, 90-95% of them will have type 2 diabetes.
  • It is estimated that an additional 450,000 Canadians may have diabetes without being aware of it.
  • Between 1998/99 and 2008/09, the prevalence of all forms of diabetes among Canadians increased by 70%. This increase may be related to increases in rates of overweight and obesity. The greatest relative increase in prevalence was seen in the 35 to 39 and 40 to 44 year age groups, where the proportion doubled.
  • If current trends continue, it is estimated that there will be 3.8 million Canadians living with diabetes by 2018/19.
  • The overall prevalence of diabetes was higher among males (7.2%) than females (6.4%).
 

Prevalence by geographic region

  • Newfoundland and Labrador, Nova Scotia, and Ontario had the highest age-standardized rates of people living with diabetes in Canada while Nunavut, Alberta, and Quebec had the lowest.
 

Aboriginal peoples and diabetes

  • Compared to the overall Canadian population, type 2 diabetes is 3 to 5 times higher among First Nations people and rates are increasing among the Inuit.
 

For more facts and figures:

 

Risk factors

Several factors contribute to a person’s risk of developing type 2 diabetes. Some of these risk factors such as getting older, a family history of diabetes or belonging to certain high-risk ethnic populations (e.g. Aboriginal, African, Hispanic American, South Asian or Chinese ancestry) cannot be changed. In addition, people living with medical conditions such as metabolic syndrome, high blood pressure, elevated cholesterol levels, depression and schizophrenia are at higher risk of diabetes. Women who have experienced gestational diabetes are also more likely to develop type 2 diabetes.

On the other hand, diabetes has been linked to a number of risk factors that can be changed such as overweight/obesity, poor diet, and physical inactivity. Action on these modifiable risk factors can reduce the risk of diabetes and prevent a range of other medical conditions.

It is not known what causes type 1 diabetes, but it is hypothesized that both genetic factors and exposure to viruses are involved.

For more information on risk factors:

 

Strategies

A number of strategies have been developed to prevent diabetes by addressing modifiable risk factors.

Canadian strategies

  • The Canadian Diabetes Strategy by the Public Health Agency of Canada focuses on the key elements of surveillance, public education, and community-based programs – as well as on common risk factors for major chronic diseases, including diabetes.
  • The Aboriginal Diabetes Initiative from Health Canada aims to reduce type 2 diabetes among Aboriginal people by supporting health promotion and primary prevention activities and services delivered by trained community diabetes workers and health service providers.
  • The Pan-Canadian healthy living strategy from the Public Health Agency of Canada outlines a prevention and health promotion strategy for chronic diseases that focuses on supporting sectors to align and coordinate work efforts to tackle common risk factors such as poor nutrition and physical inactivity.

Provincial strategies

A number of provinces include primary prevention in their diabetes strategy.

Alberta

Manitoba

New Brunswick

Newfoundland and Labrador

Nova Scotia

Ontario

Yukon

International

Scotland

  • The Diabetes Improvement Plan by the Scottish Government (2014) identifies a number of key priority areas required to deliver improved prevention, treatment and care for citizens affected by diabetes.

World Health Organisation

For information on secondary prevention:

Screening tests can help identify diabetes early so that interventions can be started as soon as possible. Many of the provincial diabetes strategies described in the section on Primary prevention provide information on early identification of diabetes.

The Canadian Diabetes Risk Questionnaire (CANRISK), from the Public Health Agency of Canada is a self-completed tool that assists Canadians in finding out if they are at risk for pre-diabetes or type 2 diabetes (2011).

 

Guidance

Canada

Screening for type 2 diabetes (2012) by the Canadian Task Force on Preventative Health Care provides guidance for clinicians and policy-makers on screening asymptomatic adults for type 2 diabetes.

International

United Kingdom

The NICE guideline Preventing type 2 diabetes: Population and community-level intervention (2011) provide population and community-level recommendations for prevention of type 2 diabetes in high risk adults such as integrated national strategies/activities to prevent other non-communicable diseases.

 

Surveillance

Surveillance refers to the systematic, regular collection, analysis and interpretation of data for a given population, to detect changes in patterns of disease or determinants of disease, with action taken if predefined criteria for thresholds are met.

Sources of information on surveillance for diabetes:

  • The Public Health Agency of Canada’s Canadian Chronic Disease Surveillance System, previously known as the National Diabetes Surveillance System, uses population-based administrative data from provinces and territories to provide detailed, comparative information for assessing the scope, as well as the use of health services and health outcomes of chronic diseases, including diabetes. Data from population health surveys and vital statistics provide additional data on diabetes, its risk factors and complications.
  • The Public Health Agency of Canada: provides Chronic Disease Infobase Data Cubes are interactive databases that allow users to create tables and graphs using their web browser and interactive maps providing current statistics on priority chronic disease and risk factor prevalence in Canada for diabetes as well as for other non-communicable diseases.
  • Statistics Canada Diabetes Data tables (2013) and map (PDF document), (2009/10).
  • Data Table from Statistics Canada by subject: Diseases and health conditions, including Diabetes.
 

Provincial-territorial surveillance

Alberta

 

Atlantic

 

Manitoba

 

New Brunswick

 

Saskatchewan

International

United States

  • The Diabetes Atlas provides data, statistics, and trends at the national, state and county levels on the public health burden of diabetes and its complications in the United States.

World Health Organisation

 

Publications

Canadian

International

World Health Organisation

United States

 

Provincial/Territorial Diabetes Sites

Alberta

  • Healthy U: provides information on healthy lifestyle choices to prevent diabetes and other chronic diseases.

British Columbia

  • Healthy Families BC, provides information on healthy lifestyle choices to prevent diabetes and other chronic diseases.
 

Manitoba

 

New Brunswick

  • Healthy People, provides information on how to live well with diabetes.
 

Newfoundland

 

Nunavut

  • Chronic Disease, provides information on risk factors for chronic diseases with links to information on healthy lifestyle choices to prevent them.
 

Ontario

 

Prince Edward Island

  • Diabetes Program of PEI, provides information about living with diabetes, information on diabetes prevention and information for health professionals working with people living with diabetes.
 

Quebec

  • Le diabète, (French only) resources and publication on diabetes prevention and management.
  • Diabetes Quebec, has a broad range of information for the public on diabetes.
 

Saskatchewan

  • Healthy Living, provides information on healthy lifestyle choices to prevent diabetes and other chronic diseases.
 

Tools and Resources

For health professionals

Canadian resources

 

International resources

United Kingdom
United States
  • The Centres for Disease Control: Diabetes Public Health Resource, provides a range of information the impact of the disease, influence health outcomes, and improve access to quality health care.
 

Systematic Reviews