National Statistics and Opportunities for Improved Surveillance,
Prevention, and Control

INTRODUCTION

Diabetes is now being recognized as a public health problem of potentially enormous proportions. Over a million Canadians are currently living with diabetes, and age-standardized rates of diabetes among Aboriginal peoples are triple those found in the general population. Recent comparative national surveys show prevalence rates of diabetes to be on the increase; as the Canadian population ages and rates of obesity rise, this trend is expected to worsen. Diabetes is a major cause of heart disease, and a leading cause of blindness, kidney failure, and limb amputations. Diabetes is ranked as the seventh leading cause of death in Canada, and it accounted for approximately 25,000 potential years of life lost due to premature death in 1996. The actual number of deaths for which diabetes is a contributing cause is estimated to be five times as high as current figures indicate and will increase exponentially over the next 10 years if current trends continue. In economic terms, the burden of diabetes to the Canadian population due to health care costs, disability, work loss, and premature death is estimated to be up to $9 billion annually.

Effective prevention and control measures are urgently needed to

• target modifiable risk factors for diabetes such as obesity and physical inactivity
• improve the treatment and management of diabetes
• delay or prevent debilitating complications.

The recently established Diabetes Division at the Laboratory Centre for Disease Control (LCDC), Health Canada, has compiled current national statistics on diabetes and its complications in order to provide health professionals, policy makers and the public with a clearer picture of the burden of illness of diabetes and expected future trends. The Diabetes Council of Canada (DCC), through its member organizations, has assisted LCDC by reviewing this first Diabetes in Canada report.

This report is also intended to highlight the great gaps in our knowledge about diabetes. Although a few national surveys, such as the General Social Survey (1985, 1991), National Population Health Survey (1994/95, 1996/97), and the Aboriginal Peoples Survey (1991), do provide some basic data at the national level, there is no ongoing monitoring of the following: the incidence and prevalence of Type 1 and Type 2 diabetes; incidence and prevalence of diabetes complications and disabilities; prevalence of risk factors for diabetes and its complications; diabetes management practices by health professionals and patients; ambulatory health care utilization; quality of care; provision of diabetes education; direct and indirect costs of diabetes; or effectiveness of diabetes prevention and control strategies and activities. Furthermore, there are limited data from either basic or enhanced diabetes surveillance at provincial/territorial or regional/county levels, where diabetes prevention and intervention programs are planned and implemented. We continue to rely mainly on U.S. data for a comprehensive portrait of this chronic, costly, and preventable condition.

The Diabetes Division at LCDC is currently collaborating with provincial and territorial governments, non-governmental organizations and federal agencies on the development of the National Diabetes Surveillance System (NDSS), an initiative of the Diabetes Council of Canada. The ultimate goal of this system is to provide comprehensive, ongoing monitoring of the human and economic burden of diabetes and its complications in order to support urgently needed and effective health care policies and practices.

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