We take a look at diabetes in Canada and review what’s new and what’s on the horizon.
Over 9 million Canadians are living with diabetes or prediabetes. Worryingly, PHAC (Public Health Agency of Canada) reports that 5 million Canadians over the age of 20 are currently prediabetic and this number is expected to rise to 6 million by 2016. If left untreated, at least half the people with prediabetes will develop type 2 diabetes within 8 to 10 years.
Type 2 diabetes accounts for 90% of people with diabetes, with seniors representing 45% of the total number of people with the condition. This leaves 10% with type 1 diabetes. Additionally, 4% of pregnant women are diagnosed with gestational diabetes.
Government coverage of diabetes medications and supplies varies across the provinces in Canada, with the result that some individuals and families are left to bear much of the cost themselves.
Thanks to the work of advocates across the country, both Alberta and Nova Scotia announced the introduction of funded insulin pump programs in 2013 and PEI announced their funded program in 2014. Find more information on insulin pump coverage across Canada here.
The Canadian Diabetes Association recently launched The Diabetes Charter for Canada. This is an important advocacy tool, bringing a new standard of equity for people with diabetes across Canada. It will enhance the accountability of all governments in Canada.
For resources to help with the financial burden of diabetes, see our article Sources of financial assistance for diabetes supplies.
Significant research continues in the hopes of finding a cause and cure for diabetes, but realistically a complete cure is not in the immediate future. However, there is much cause for hope in recent and current research into more effective use of medications, diabetes prevention, and new treatments for diabetes complications.
In 2013, the Canadian Diabetes Association alone invested $7.2 million in research, with major studies focused in several important areas, including the following:
- How gestational diabetes affects babies’ development
- Whole family diabetes prevention
- Aboriginal community control to lower diabetes risk
- Re-growing nerves to reverse foot and hand damage of neuropathy
For more information on neuropathy research, see our article What’s the word on neuropathy?
There have also been exciting research findings into the effectiveness of physical activity in diabetes management. Studies consistently show that both aerobic and resistance exercise are effective in improving blood glucose levels in type 2 diabetes, but that the combination of both types of exercise is at least twice as effective as either activity alone. The strongest evidence for this was reported in the DARE (Diabetes Aerobic Resistance Exercise) study.
2013 Revised Clinical Practice Guidelines (CPGs)
As a result of the above studies into the effects of physical activity, the revised 2013 Clinical Practice Guidelines now include a recommendation for most people with diabetes to engage in both types of exercise.
Other important changes in the CPGs include the expansion of the diabetes ABCs to the ABCDEs.
These are the ABCDEs:
A stands for A1C. Keep up to date with A1C tests and aim for an A1C of less than 7%.
B stands for Blood pressure. Aim to keep your blood pressure around the optimal level of 130/80 mmHg.
C stands for Cholesterol. Target an LDL cholesterol level of below 2.0 mmol/L.
D stands for Drugs to protect the heart and help reduce the risk of vascular disease.
E stands for Exercise/Eating. Establish and follow a healthy lifestyle program of nutritious eating and regular physical activity.
S stands for Smoking cessation. If you smoke, get help to quit!
Keep track of your progress with the Diabetes Self-Management Tools available on this site.
The CPGs also introduced three important sets of new numbers related to diagnosis of diabetes, pre-diabetes and gestational diabetes. For full details, please see our expert blogger’s valuable article Revised guidelines for diabetes management: part 3.