Diabetes: An Investment for the Future Health of Canadians Diabetes is a major public health issue today in Canada and worldwide. …
Diabetes: An Investment for the Future Health of Canadians
Recommendations for the Consideration
of the
House of Commons Standing Committee on Health
from the
Canadian Diabetes Association
30 October 2003
Summary
Diabetes is a major public health issue today in Canada and worldwide
Already at epidemic proportions, it is estimated that by 2010 over 220
million people around the world will be living with diabetes
Today, 2 million Canadians live with diabetes - or put another way - 1 in
13 Canadians lives with diabetes And the numbers will increase as new
scientific evidence recommends earlier screening of people at high risk for
diabetes - thereby identifying another 25 million Canadians at-risk of
diabetes
Based on a recent report that outlines the costs of diabetes in America,
the cost of this chronic disease to Canadian society was estimated at 132
billion in 2002 - up significantly from the 9 billion in
1998 Costs will
continue to escalate to an estimated 156 billion by 2010 unless action is
taken
New scientific evidence indicates that earlier diagnosis and aggressive
treatment with multiple drug therapies are required to prevent
cardiovascular complications in particular Scientific medical evidence
shows that 80 of Canadians living with diabetes will develop heart disease
and/or strokes Diabetes also contributes to a host of serious
complications if not managed well Kidney disease, blindness and
amputations are just a few of the well-known complications that
substantially increase Canadas health care costs
Less well-known is the fact that infectious diseases - whether the common
cold, winter flu, SARS or the West Nile virus - affect people living with a
chronic disease like diabetes harder and more virulently than other
Canadians
Canadians are also aging and obesity rates are rising across our country
Both are high risk factors in diabetes Frighteningly, the proportion of
children and adolescents who are overweight has tripled in the past 30
years, and — fat kids become fat adults
Diabetes creates a heavy financial burden both to the individual and to
government, yet it
- and the expensive complications associated with the
disease - can often be prevented if action is taken early on
Diabetes doesnt wait The Canadian Diabetes Association asks the Committee
to please act now and invest in a healthier future for Canadians both with,
and at risk for, diabetes
There has never been a more urgent time to act Please consider
recommending the following in your report on the health aspects relating to
patented and generic prescription drugs:
Provide federal funding for an enhanced five-year renewal of the
federal National Diabetes Strategy whose current federal funding ends
31 March 2004
Ensure timely access to medications and supplies that can improve the
quality of life for Canadians living with diabetes Timely access may
decrease the likelihood of future interventions for complications
List new prescription drugs and products with proven efficacy in a
timely fashion
Should a product be discontinued, ensure Canadians dependent on that
product have access either to that treatment or to a viable
alternative that meets their needs
Ensure that the cost of diabetes medication, supplies and
medical
devices, as well as the cost associated with diabetes-related
complications, are not a barrier or a burden for Canadians living with
diabetes
Ensure government efforts to control drug costs are not undertaken in
ways that restrict patient access to therapeutics which could improve
long-term health and improve quality of life, increase costs borne by
the patient or restrict physicians options to prescribe
Ensure the common drug and medical device review process is timely,
transparent and incorporates a functional post-market surveillance
system which we believe is essential for the health of all Canadians
INDEX
INTRODUCTION
Diabetes in Canada Page 4
THE ECONOMIC COSTS OF DIABETES
Economic costs to society Page 5
Case Study 1: Glenn Richards Page 7
Economic costs to individual Canadians Page 7
Case Study 2: Laurel Jungwirth Page 9
Case Study 3: Christina Beyer Page
10
RECOMMENDATIONS
Future direction: Pay nowor pay more later Page 11
Diabetes doesnt wait: policy implications Page 13
ATTACHMENTS
A Canadian Diabetes Strategy 1999-2004 Page 13
Who we are: Canadian Diabetes Association Page 15
What is diabetes? Page 15
INTRODUCTION
Diabetes in Canada
Nearly 2 million Canadians have diabetes today and that number continues to
grow as at least 60,000 Canadians each year discover from their doctor that
they have diabetes
A whole lot more Canadians need to know they are also at risk for diabetes
The latest scientific evidence reflected in the 2003 Clinical Practice
Guidelines for the Prevention and Management of Diabetes clearly identifies
another 25 million Canadians who are now at-risk for diabetes
Recent scientific evidence has also positioned our view of how to
potentially prevent type-2 diabetes in high-risk individuals; diagnose
diabetes earlier; and aggressively manage all types of diabetes New risk
factors identify the importance of associated risk factors, particularly
cardiovascular and
other associated conditions such as schizophrenia,
polycystic ovary syndrome, and a lowering of age risk from 45 to 40, as
factors in support of earlier screening and diagnosis
In the past, children and youth were generally diagnosed with type-1
diabetes A child or youth diagnosed with type-2 diabetes was unusual
This picture is rapidly changing unfortunately High-risk Canadian children
and youth are increasingly diagnosed with type-2 diabetes Recent research
in the United States predicts that 1 out of 3 American children born in
2000 will be diagnosed with diabetes in their lifetime We anticipate
similar rates for Canadian children given that the proportion of children
and adolescents in Canada who are overweight has tripled in the last 30
years, and our high-risk immigrant population continues to increase Fat
kids become fat adults, and excess weight is a well-known risk factor for
diabetes
Diabetes amongst senior Canadians is at epidemic levels One in 10
Canadians aged 65 and older lives with diabetes Source: Statistics
Canada, Health Reports, Winter 1997, v9, no 3, p 49 And as our baby-
boom generation ages, the number of Canadians living with type-2 diabetes
will
inevitably increase unless action is taken to prevent where possible
this progression In Ontario, persons with diabetes aged 75 and older
visit a family physician, specialist or optometrist almost twice per month
on average
First Nations, Inuit and Metis are 3 times more likely to have type-2
diabetes and they are more likely to have it earlier than other Canadians
According to the 1991 Aboriginal Peoples Survey the most recent survey,
the prevalence of diabetes is 85 among First Nations living on-reserve or
in Aboriginal communities, 53 among First Nations living off-reserve,
55 among Metis and 19 among Inuit people Diabetes is and will remain
at epidemic levels in Aboriginal communities across Canada unless action is
taken now
77 of new Canadians are from populations known to be of high risk for type-
2 diabetes, According to Statistics Canada Over 57 of immigration to
Canada for example, come from Asia and they - along with African and
Hispanic populations - are known to be at high risk for type-2 diabetes
As Canadians from these populations age, the numbers with type-2 diabetes
will also increase
The economic costs of diabetes
Like a pebble thrown into a pond the impact
of diabetes ripples across
Canadian society - affecting family, friends, employers, business,
industry, governments and the overall capacity of our health care system
The fact is that diabetes creates a heavy financial burden both to the
individual and to government, yet it - and the expensive complications
associated with the disease - can often be prevented if action is taken
early on
New research strongly endorses earlier diagnosis, as well as more
aggressive treatment of diabetes in order to manage the disease better, and
reduce or delay the onset of complications for the individual This
aggressive treatment will mean the physician recommends a quicker move to
single or multiple therapies for her or his patient Tighter targets for
blood pressure, lipids and glucose will require more testing and earlier
treatment for these factors Patients are being told to take an active
role in managing their diabetes, and will know to ask their doctor for the
right tests at the right time
Canadians living with diabetes learn quickly the concept of pay now or
pay more later Their commitment to vigilant care and management of their
diabetes 24 hours a day, 7 days a week is the only way
for them to achieve
an optimal quality of life and delay or prevent traumatic complications
Governments must respect this concept and invest now for better health
outcomes for Canadians with diabetes as well as to reduce the future
escalating costs - both to the individual and to society
Economic costs to society
Based on a recent report that outlines the costs of diabetes in America,
the cost of this chronic disease to Canadian society was estimated at 132
billion in 2002 - up significantly from the 9 billion in 1998 Costs will
continue to escalate to an estimated 156 billion by 2010 unless action is
taken Source: Harris, Canadian Diabetes Strategy: Time for Action, May
2003
Additional studies have noted that direct medical costs associated with
diabetes care - before even considering complications - is estimated to be
573 million Complications associated with diabetes escalate the costs to
society dramatically For example, 80 of Canadians living with diabetes
will develop cardiovascular complications Other diabetes-related
conditions include hypertension, amputations, erectile dysfunction, kidney
disease, lower respiratory tract infection, and skin disease
In
1999/2000, the proportion of hospitalizations for these conditions was
consistently higher among Canadians with diabetes than amongst those
without it It costs 50,000 each year to provide kidney dialysis for one
Canadian living with diabetes It costs 74,000 for a leg amputation
Diabetes also contributes to the costs associated with infectious disease
as well as chronic disease In a recent review of the 144 probable SARS
cases in Toronto, older Canadians or those with a chronic disease such as
diabetes, were significantly more likely to be admitted to an intensive
care unit and had a far greater risk of not surviving Source: Journal
of the American Medical Association, 2003: 289: 2801-2809
SARS reminds us that infectious disease heavily impacts those Canadians
living with a chronic disease or lowered immune systems, however government
investing solely in the prevention of infectious disease or the promotion
of healthy living will do nothing to contain the escalating costs
associated with diabetes Diabetes requires a complementary - but
different - framework to help government contain future costs
Yet if government invests now to support the prevention of
expensive
complications such as heart disease, strokes, kidney or liver failure, limb
amputations and blindness amongst Canadians living with diabetes, our acute
care hospital costs across Canada will be lower as a result
Case Study 1: Glenn Richards is a 40-year old merchant from Outlook,
Saskatchewan who has lived with type-1 diabetes since he was diagnosed at
12
As a person with diabetes, are you able to access the assistance you need
to be able to manage your diabetes well? Theres a lack of specialists in
our province Theres a long waiting period before you can see a
specialist Both my daughter and I have Type 1 diabetes and we experience
a high financial burden If you have certain other diseases in Canada you
can get 100 coverage There are more and more people with diabetes in
Canada, yet there is very little support for them
What are the obstacles, if any, that you face in being able to live well
with diabetes?
Insurance coverage is more costly We have to eat well, so theres an
increased cost for our food The major obstacle is the cost of diabetes
supplies My daughter and I each test four times a day and the cheapest
that weve been able to purchase strips is 74
cents per strip Weve
applied for financial assistance from the provincial government and been
told that we make too much money to qualify for the governments Special
Support Program That means that my family pays about 5,000 out of pocket
for our diabetes supplies, insulin, test strips and syringes every year,
medications and supplies that we need to stay alive
Lets have a level playing field If my daughter and I had cystic fibrosis
our costs would be covered Why is it not the same for diabetes?
Diabetes management requires a multifaceted support that includes
appropriate medications and tools and resources such as blood glucose
monitoring A full appreciation and support for all management
requirements is essential
Economic costs to individual Canadians
Good management of diabetes can help contain costs for diabetes-related
conditions And for Canadians living with diabetes, the incentive to
manage their disease effectively is living well Yet there is also a
disincentive built into our economic system for a Canadian living with
diabetes Estimates show that the personal cost of managing diabetes is 5
times higher than the personal costs incurred by other Canadians each
year
for medical-related drugs and supplies
A significant number of Canadians living with diabetes are not covered by
an employee benefit plan or private insurance Our Diabetes Report Card
2001 showed that the cost and access to diabetes-related drugs and supplies
under provincial health systems for a Canadian living with diabetes varies
widely across our country Depending on where they live in Canada, an
individual with diabetes can face severe financial hardship when trying to
manage their diabetes well
To monitor progress and changes to diabetes management, self-blood glucose
monitoring is a widely accepted practice An individual with type-1 or
type-2 diabetes will need to test several times a day to manage
effectively In type-2 diabetes, 3 or more tests a day have been
associated with a statistically and significant 1 reduction in AIC levels
In people with type-2 diabetes treated with medications, testing at least
once a day is associated with 06 lower AIC than less frequent testing
In many situations, more frequent testing may be required to provide the
information needed to make behavioural or treatment adjustments required to
achieve blood glucose levels
In some
provinces, drug plans pay for the blood glucose test strips In
other provinces, the Canadian living with diabetes must pay for their test
strips entirely And in other provinces, government will co-pay up to a
specified amount each year, particularly for low-income Canadians
Preferred management regimes include an aggressive approach to glucose
management that includes insulin, oral medications, ketone strips,
syringes, glucose testing meter, frequent visits to doctors and
specialists, sharps disposal, specialized home care visits, specialized
foot care, and additional medications for co-morbid conditions For the
person with type-1 diabetes, the use of an insulin pump may be desired or
recommended to attain required glucose targets
Indirect costs associated with diabetes include: premium rates on
insurance and higher insurance deductibles, increased travel costs to
access diabetes care and education particularly for Canadians living in
rural and remote communities, additional costs for fresh food for all but
particularly for Canadians living in rural and remote communities,
increased child care costs for parents of a child with diabetes, and
special footwear
For Canadians
living with diabetes, these additional costs associated with
diabetes add up, and depending on where you live - in an urban, rural,
remote or northern community - can vary significantly If you include only
medications and supplies, the range of additional costs can be from 1,000
to 5,000 a year, while the inclusion of indirect costs can increase that
range up to 10,000 a year
Should an individual undertake intensive diabetes management using an
insulin pump, the initial cost of the equipment is 6,000, and on-going
costs will range from 500 to 600 a month
Case Study 2: Laurel Jungwirth has lived with type-1 diabetes for 23
years On a monthly basis she spends between 362 to 456 to purchase the
basic medications and supplies she needs to manage her diabetes When she
is unwell - with the flu or a cold for example - she needs to test her
blood glucose tests and usually needs to increase her insulin intake Her
costs for managing her diabetes include:
INSULIN
Humulin N 361 per day
49 units per day @ 8 cents per unit
3680 for 500 units
Humalog 088 - 175 per day
8 - 16 units per day @ 11
cents per unit
5262 for 500 units
NEEDLES
BD Ultra-fine pen needles 177 per day
6 needles per day @ 29 cents per needle
2937 for 100 needles
BLOOD GLUCOSE MONITORING
One Touch Ultra 100 393 - 590 per day
4 - 6 test strips per day @ 98 cents per strip
9817 for 100 strips
Lancets 039 - 058 per day
4 - 6 lancets per day @ 9 cents per lancet
960 for 100 lancets
KIDNEY PROTECTION
Altace Ramipril 111 per day
1 pill 5 mg per day @ 111 per pill
3766 for 34 pills
Total cost to Laurel: 1169 - 1472 per day
426685 - 537280 per year
Canadians living with diabetes already carry a significant proportion of
the financial burden of managing their diabetes With the science now
recommending very aggressive treatment of diabetes, the cost of managing
their diabetes will escalate - both for the individual and for society
Without their active participation in managing their disease well, society
would be paying even more for treatment of the resulting complications,
as
well as foregoing their economic contribution to Canadas GDP
Case Study 3: Christina Beyer has lived with type-1 diabetes for 8 years
She lives with her daughter outside Toronto
As a person with diabetes, are you able to access the assistance you need
to be able to manage your diabetes well?
For the most part, I am able to access my endocrinologist and diabetes
supplies I am currently using an insulin infusion pump to manage my
diabetes As a result, my supplies are very expensive Not only do I
require insulin pump supplies, but I also test my blood sugar about 8 -10
times per day Recently, my extended health care provider denied me full
coverage They only compensate for 4 tests per day Because I want to
manage my diabetes well, I pay the additional costs
What are the obstacles, if any, that you face in being able to live well
with diabetes?
A major obstacle for me has come from the insurance industry I am a
healthy 36-year old, with absolutely no complications from my diabetes I
am also recently legally separated and under this agreement, I am obliged
to carry life insurance The life insurance provider of my employers
benefits package has denied me coverage
Extensive research to find a
company that will cover me at a fair price has proved difficult Premiums
are often quoted at approximately 300 more than an individual in good
health without diabetes I am not yet covered
I am surprised by the lack of required education on the part of insurance
companies and their underwriters One of their detailed forms inquiring
about my diabetes asked how often do I test my urine for glucose? Most
companies today should know that testing urine for glucose on a daily basis
is an outdated method of managing diabetes
Future direction: Pay nowor pay more later
The Canadian Diabetes Association believes that society has a choice to
make for the future health of all Canadians
Population health approaches to healthier lifestyles and good nutrition are
essential to improve the health of Canadians generally, and will certainly
address the need for greater chronic disease prevention of which diabetes
is a model But healthier living strategies on their own are not enough to
address the diabetes epidemic today in Canada A renewed commitment to an
enhanced federal National Diabetes Strategy is required to concentrate our
efforts to reach out to the
60,000 Canadians who will be diagnosed with
diabetes this year
A renewed federal National Diabetes Strategy is required to focus diabetes
prevention and screening programs at those Canadians - Aboriginal, Asian,
Latin American, African, overweight kids and youth - who are at high risk
of developing type-2 diabetes Earlier diagnosis and more aggressive
management with multiple therapies can impact the burden of complications
for both the individual and the Canadian economy A renewed commitment to
an enhanced federal National Diabetes Strategy should also coordinate
existing federal and provincial strategies and programs to maximize
beneficial outcomes and reduce duplication and overall costs associated
with diabetes for all Canadians All aspects of prevention - primary,
secondary and tertiary - is urgently required
A renewed commitment to an enhanced federal National Diabetes Strategy
should:
create new diabetes programs and strategies to break through cultural,
linguistic and socio-economic barriers to address the needs of high
risk populations,
develop new diabetes programs and encourage research to address high
risk populations including children and
youth, seniors, obese
individuals, and pregnant women diagnosed with type-2 diabetes,
support the implementation of the Canadian Diabetes Associations new
2003 Clinical Practice Guidelines for the Prevention and Maintenance
of Diabetes,
expand existing Aboriginal Diabetes Initiative to address the serious
epidemic across Canada,
integrate and support diabetes primary prevention campaigns and
messages with other supportive strategies, and
sustained support for the National Diabetes Surveillance System NDSS
A renewed federal commitment to an enhanced National Diabetes Strategy will
- in our opinion - have the potential to:
Encourage supportive strategies to delay or prevent the diagnosis of
type-2 diabetes in high-risk populations,
Support the early diagnosis and aggressive management of diabetes with
the potential to decrease complications and the financial and personal
burden of diabetes for Canadians,
Address the urgency to establish requirements of high-risk
populations, in particular Aboriginal and new immigrant Canadians, and
Establish a monitoring and tracking system that positions the
magnitude
of the problem and facilitates accountability for
measurement of new programs and strategies
Diabetes doesnt waitpolicy implications
New scientific evidence compiled in the 2003 Clinical Practice Guidelines
for the Prevention and Treatment of Diabetes recommends:
Aggressive assessment of risk
Aggressive and timely management of blood glucose
Aggressive management of blood pressure and lipid levels
Recognition of diabetes as a cardiovascular disease
Earlier diagnosis and the immediate use of multiple drug therapies in order
to prevent and/or delay devastating and costly complications will require
federal, provincial and territorial governments to act quickly to contain
Canadas diabetes epidemic
There has never been a more urgent time to act Please consider
recommending the following in your report on the health aspects relating to
patented and generic prescription drugs:
Provide federal funding for an enhanced five-year renewal of the
federal National Diabetes Strategy whose current federal funding ends
31 March 2004
Ensure timely access to medications and supplies that can improve the
quality of life for Canadians living
with diabetes Timely access may
decrease the likelihood of future interventions for complications
List new prescription drugs and products with proven efficacy in a
timely fashion
Should a product be discontinued, ensure Canadians dependent on that
product have access either to that treatment or to a viable
alternative that meets their needs
Ensure that the cost of diabetes medication, supplies and medical
devices, as well as the cost associated with diabetes-related
complications, are not a barrier or a burden for Canadians living with
diabetes
Ensure government efforts to control drug costs are not undertaken in
ways that restrict patient access to therapeutics which could improve
long-term health and improve quality of life, increase costs borne by
the patient or restrict physicians options to prescribe
Ensure the common drug and medical device review process is timely,
transparent and incorporates a functional post-market surveillance
system which we believe is essential for the health of all Canadians
Delaying the onset of diabetes, as well as delaying the
complications
associated with diabetes will in our view help contain future costs within
Canadas public health care system, while allowing Canadians to participate
more fully in our country Please act
ATTACHMENT A
The first Canadian Diabetes Strategy 1999-2004
In 1999, the federal government invested 115 million in a 5-year Canadian
Diabetes Strategy That investment ends on March 31st, 2004
Conscious of the human, social and economic impacts of diabetes, the
federal government worked collaboratively in this long-term effort to build
the foundation needed to prevent, control and combat diabetes in a
coordinated way across Canada The objective was to address the problem at
two levels 1 raising Canadians awareness of how they can prevent
diabetes and its complications; and 2 supporting improved monitoring of
diabetes in the population, with an eye to improving the planning and
evaluation of future diabetes reduction strategies
There were four components under the Canadian Diabetes Strategy:
1 Aboriginal Diabetes Initiative 58 million
2 Prevention Promotion 418 million
3 National Diabetes Surveillance System 108 million
4
National Coordination 44 million
The federal, provincial and territorial ministries of health, national
Aboriginal organizations, national and provincial/territorial non-
government organizations, consumers, industry and health professionals were
all partners in drafting the Blueprint for Action which confirms the need
for a National Diabetes Strategy
The Canadian Diabetes Association was a partner in a number of good
projects that were funded under this strategy We worked in collaboration
with the organizing committee to plan and hold a national symposium to
develop a National Diabetes Strategy This national symposium was held in
3-6 May 2003 in Winnipeg with over 250 participants from across Canada
The final Blueprint for Action approved by participants will be released
shortly by Health Canada
Our Association was also the primary partners involved in two other
projects funded by the Canadian Diabetes Strategy One was entitled
Healthy Eating is in Store for You and the second entitled the Workplace
Wellness Program
Examples of other projects funded under the Prevention Promotion section
of the national strategy included:
Diabetes in Older Adults from Hispanic, Black
and Asian Populations
National
Moving Growing II: Preventing Diabetes through Physical Activity in
Young Children National
London Latin American Community Outreach for the Prevention of
Diabetes Ontario
Diabete chez les jeunes en milieu scolaire Quebec
Healthy Eating and Active Living HEAL in Northern BC British
Columbia
Identification of Best Practice Models for Diabetes Prevention
Programs for Ethno-cultural Communities Nova Scotia
Preventing Type-2 Diabetes Among Inner City School-Aged Children
Alberta
Diabetes Strategy in Winnipeg for Seniors Manitoba
There were also 39 successful projects funded under the Aboriginal Diabetes
Initiative that focused on primary prevention programs and services for
Metis, off-reserve Aboriginal peoples and urban Inuit
The National Diabetes Surveillance System has been developed and
implemented including the governance, info-structure and establishment of
provincial, territorial and federal partnerships, as well as capacity
building and data-sharing agreements While less direct in its apparent
benefits for individual Canadians living with diabetes, surveillance is
crucial
for an accurate national picture of diabetes and its effects on
Canadians Health care professionals can use the information and
perspectives derived from surveillance to develop effective programs that
ultimately help Canadians prevent and control the disease
Finally, the 5-year strategy brought together a broad range of diabetes
stakeholders, representing a wide diversity of backgrounds and
perspectives, to collaborate in the development of a true National Diabetes
Strategy that would integrate and coordinate efforts across Canada The
goal was to avoid duplication and maximize limited resources by building on
existing achievements and activities
The federal governments initial investment of 115 million in 1999 laid
the foundation for a truly national diabetes strategy that would help
prevent diabetes before it developed, and help prevent the costly
complications after it was diagnosed It facilitated the ability to
understand the tip of the iceberg, but we must now invest further to
ensure a better future for Canadians living with - or at high risk of -
diabetes
The draft Blueprint for Action outlines the next steps in building this
unique national strategy The Canadian
Diabetes Association is concerned
however that without a renewal of investment in an enhanced national
diabetes strategy, implementation of the plan will stall, and the initial
115 million investment by the federal government lost
ATTACHMENT B
Who we are
The Canadian Diabetes Association is an independently governed charitable
organization focused on the needs of Canadians affected by diabetes
Started in 1953, our Association is celebrating our 50th anniversary with
our professional and general members at our annual meetings in October this
year Our National Board of Directors is elected by our membership We
are present in over 150 communities across Canada Through the hard work
and dedication of thousands of volunteers, the Canadian Diabetes
Association has become the leading organization in Canada dealing with
diabetes and with persons affected by diabetes
The Association is also a member of a number of national health alliances
including, the Diabetes Council of Canada, the Chronic Disease Prevention
Alliance, the Healthy Living Network, the Health Charities Council of
Canada, and the Best Medicines Coalition We support these
alliances
because we believe that by working together on areas of common interest and
shared concern our voice will be heard by policy and decision-makers We
also believe we can identify areas where government action will benefit the
greatest number of Canadians while potentially containing overall costs to
society A win-win situation
What is diabetes?
Diabetes is a serious chronic disease that impairs the bodys ability to
use food properly When you consume a meal, your body converts the sugars
and starches to glucose sugar In order to metabolize glucose properly,
your body needs insulin, which is a hormone produced by the pancreas, a
gland located just beneath your stomach Insulin regulates the bodys use
of glucose, preventing a buildup of sugar in the bloodstream and ensuring
that various tissues have sufficient glucose to function efficiently
Without insulin, glucose levels increase dramatically in the bloodstream
and urine - and this is what we call diabetes
Researchers have classified diabetes into three types: type-1, type-2 and
gestational Type-1 diabetes is caused by an autoimmune reaction where the
body destroys healthy insulin producing beta cells in the
pancreas As a
result, there is little or no insulin produced, and you need life-
sustaining injections of insulin to live Risk factors for type-1 diabetes
include race or ethnicity and whether your mother or father has type-1
diabetes
Type-2 diabetes is what 90 of all Canadians living with diabetes have, and
in this form, the pancreas produces insulin, but for some reason your body
is unable to use it effectively Type-2 diabetes can be managed by healthy
eating, losing weight and physical activity In time, people with type-2
diabetes may require oral drugs or insulin injections The risk factors
for type-2 include age, obesity, family history, physical inactivity, and
race or ethnicity
Gestational diabetes is a temporary condition that affects 2 - 4 of
pregnant women The hormonal changes of pregnancy stress the mothers
system, and in some cases, the pancreas is unable to produce sufficient
insulin Treatment includes nutritional and physical activity, and if
necessary, insulin therapy While this type of diabetes usually disappears
after birth, 30 - 40 of women who have gestational diabetes will develop
type-2 within 5 to 10
years
Source:diabetes.ca
