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.
Public Health Agency of Canada projects
Diabetes Funded Programs at the Public Health Agency of Canada:
- Diabetes, healthy feet and you, (2012).
- Guide to Diabetic Retinopathy (PDF document), (2012).
- Diabetes strategy for pharmacists (PDF document), (2012).
- Best and Promising Practices in Diabetes Education (PDF document) (2012).
- 2011-2012 Canadian Diabetes strategy community-based program projects-Funded projects.
- Reducing Health Disparities Related to Diabetes: Lessons Learned Through the Canadian Diabetes Strategy Community-Based Program, (2011).
- Bridging the gaps: An Atlantic diabetes forum (PDF document), (2011).
- Canadian Diabetes Association – Hispanic Nutrition Tool (PDF document), (2010-11).
Nutrition, Metabolism and Diabetes Institute (Canadian Institutes of Health Research)
- Canadian Institutes of Health Research, database of funded projects on diabetes.
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:
- Public Health Agency of Canada Maternal Diabetes in Canada Fact Sheet (2014).
- Public Health Agency of Canada’s Canadian Chronic Disease Surveillance System Reports.
- Health Canada’s First Nations, Inuit and Aboriginal Health’s Web page Aboriginal Health Research – Reports and Publications has reports which provide more data on diabetes among Aboriginal peoples.
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:
- Diabetes website from the Public Health Agency of Canada.
A number of strategies have been developed to prevent diabetes by addressing modifiable risk factors.
- 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.
A number of provinces include primary prevention in their diabetes strategy.
Newfoundland and Labrador
- Improving health together: A policy framework for chronic disease prevention and management in Newfoundland and Labrador (PDF document), (2011).
- Ontario Diabetes Strategy, from the Government of Ontario.
- Diabetes: Strategies for Prevention Report of the Chief Medical Office of Health, Ministry of Health and Long-term Care.
- 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
- Global action plan for the prevention and control of NCDs 2013-2020 This action plan provides a road map and a menu of policy options including that of a 25% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2025.
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).
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.
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 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.
- The burden of diabetes in Atlantic Canada (PDF document)Atlantic Region, Public Health Agency of Canada (2011).
- 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
- Public Health Agency of Canada’s National Diabetes Surveillance System, Reports.
- Diabetes facts from the Public Health Agency of Canada.
- Canadian Journal of Diabetes from the Canadian Diabetes Association.
- Diabetic Foot Canada e-journal from the Registered Nurses Association of Ontario and the Canadian Association of Wound care.
World Health Organisation
- World Health Organisation Publications on Diabetes.
- Centres for Disease Control and Prevention’s, Diabetes Public Health Resource.
- Healthy U: provides information on healthy lifestyle choices to prevent diabetes and other chronic diseases.
- Healthy Families BC, provides information on healthy lifestyle choices to prevent diabetes and other chronic diseases.
- Diabetes Prevention: tips for healthy living, provides information on healthy lifestyle choices to prevent diabetes.
- Healthy People, provides information on how to live well with diabetes.
- Improving health my way: program to help people live with the challenges of a chronic disease, a chronic disease self-management program.
- Chronic Disease, provides information on risk factors for chronic diseases with links to information on healthy lifestyle choices to prevent them.
- Diabetes Prevention Guide, provides information on healthy lifestyle choices to prevent diabetes.
- Stand Up to Diabetes: Ontario Ministry of Health and Long Term Care, provides information for the public on diabetes tests, prevention and management.
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.
- Healthy Living, provides information on healthy lifestyle choices to prevent diabetes and other chronic diseases.
For health professionals
- Canadian Best Practices Portal, is a virtual front door to community and population health interventions related to chronic disease prevention and health promotion.
- Canadian Diabetes Association, resources for health professionals including a clinical practices guidelines toolkit and information on research.
- Canadian Institute of Health Information, database of diabetes information.
- First Nations, Inuit and Aboriginal Health, Health Canada.
- Juvenile Diabetes Research Foundation (JDRF), information on research conducted on type 1 diabetes.
- National Institute for Health and Clinical Excellence: Preventing type 2 diabetes – population and community interventions, provides information on population and community-level interventions in high-risk groups and the general population.
- 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 of the literature on prevention of diabetes from HealthEvidence.org:
- Prevention of type 2 diabetes in at-risk subjects: A systematic review and meta-analysis (2014).
- Efficacy of interventions that include diet, aerobic and resistance training components for type 2 diabetes prevention: A systematic review with meta-analysis (2014).
- Screening for type 2 diabetes in adults: An updated systematic review (2013).
- Can diabetes prevention programmes be translated effectively into real-world settings and still deliver improved outcomes? A synthesis of evidence (2013).
- Interventions for preventing gestational diabetes mellitus: A systematic review and meta-analysis (2011).