Information about Diabetes

Diabetes is a chronic disease affecting more than 5% of Canadians over 20 years of age.
It is a serious and growing public health concern in Canada, where healthcare costs of
patients with diabetes are projected to be in excess of $6 billion in 2006.

Diabetes mellitus (DM) is a chronic health condition that is associated with increased
morbidity and early mortality. Although there are different types of diabetes, administrative data such as data used for the NDSS and ADSS is presently unable to distinguish between them. It is still important, however, to recognize the different disease processes in order to assess the overall burden.

When someone has diabetes, it means that their body has difficulty making insulin and/or using the insulin that they produce. This is problematic because insulin is required to move glucose into cells so that it can be used by body tissues and organs. When glucose remains in the blood, blood glucose levels can rise to dangerously high levels and result in acute complications. Higher than normal blood glucose levels also can result in long-term organ damage and affect the eyes, kidneys and cardiovascular system.

Type 1 diabetes usually occurs early in life during childhood or adolescence. An organ called the pancreas is unable to produce insulin. This is why individuals with type 1 diabetes need to inject insulin several times a day. Type 1 diabetes accounts for 5-10% of all diabetes cases. Type 2 diabetes is usually associated with onset after 30-40 years of age; however during the past decade, type 2 diabetes has become much more prevalent in younger individuals. This is thought to be associated with lifestyle factors including physical inactivity and obesity. In type 2 diabetes, the pancreas does not produce enough insulin, or the body does not properly use the insulin it makes. Type 2 diabetes accounts for 90-95% of all diabetes cases. Gestational diabetes occurs only in pregnant women. It is a form of glucose intolerance which usually disappears after six weeks postpartum. There is evidence to suggest that women with gestational diabetes are at a higher risk of developing type 2 diabetes later in life. Physical activity and a healthy diet are indicated for all individuals with diabetes. As stated above, regular insulin injections are required for people with type 1 diabetes while those who have type 2 diabetes can sometimes be managed with exercise and diet alone. Depending on the severity of the disease, certain people who have type 2 diabetes may also need oral antidiabetic agents (e.g., pills) or even insulin to better control their blood glucose levels.

Links

• Link to the Public Health Agency of Canada
• Link to Centers for Disease Control and Prevention

Prevention of Diabetes

Type 2 diabetes, commonly referred to as adult onset diabetes, is largely associated with lifestyle factors such as being overweight, inactivity and having a poor diet.  Before a formal diagnosis of diabetes, a physician may indicate that you have pre-diabetes (impaired glucose tolerance) and are at risk of developing diabetes in the near future.  Although the ADSS cannot differentiate between type 1 and type 2 diabetes at this time, we know that both are increasing, and that type 2 diabetes (90-95% of all diabetes) is increasing at an alarming rate in developed, westernized countries.  This epidemic of diabetes largely parallels the worldwide increase of obesity in the past few decades.

The good news is that by modifying lifestyle factors, such as increasing your physical activity level and making positive changes to your diet, you may delay or prevent type 2 diabetes from developing.  There are also certain drugs that may help in the prevention of type 2 diabetes.

Treatment of Diabetes:
Prevention and Management of Complications

Once an individual is diagnosed with diabetes, it is important to reduce the risk of other comorbidities or complications that exist together with, or as a result of diabetes.  People with diabetes are at an increased risk of cardiovascular disease, kidney disease, eye disease and neuropathies that can lead to limb amputation.  Treatment, or sometimes called “secondary prevention”, is important to prevent or manage these comorbidities.

Some indicators for proper diabetes management include:

• Regular blood tests such as A1C, cholesterol and kidney function
• Good blood pressure control
• Proper weight management with adequate physical activity and a healthy diet
• Yearly eye exams
• Regular neuropathy and foot exams
• Smoking cessation
• Vaccinations

 

 

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