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1/10 Ontarians over the age of 20 have diabetes
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Diabetes rates soaring
SHERYL UBELACKER
Canadian Press
TORONTO — Cases of diabetes have risen so dramatically in Ontario — and likely the rest of Canada — that the proportion of adults with the disease has already surpassed the World Health Organization's predicted global rate for a quarter-century from now, researchers say.
A study by the Institute for Clinical Evaluative Sciences found that in 2005 almost 9 per cent of Ontarians over age 20 had diabetes, up from 5.2 per cent a decade earlier. Experts say the provincial figures mirror what is believed to be happening in the rest of Canada.
That almost 70-per-cent jump means that diabetes among our population far exceeds the 6.4 per cent worldwide prevalence rate — and the 8.4 per cent rate for developed countries alone — projected by the WHO for 2030.
“Given this linear growth in the prevalence of diabetes, more than 10 per cent of the adult population of Ontario will be diagnosed with diabetes before 2010,” said Dr. Lorraine Lipscombe, lead author of the ICES study.
Related to this article
A woman holds a vial of insulin in this file photo. (Indranil Mukherjee/AFP/Getty Images)
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“If similar trends are occurring throughout the developed world, then the magnitude of the emerging diabetes epidemic is far greater than we anticipated.”
To conduct the study, the researchers analyzed 10 years of Ontario health data to determine how many new cases of diabetes were diagnosed each year in adults over age 20. While the data do not show the form of diabetes patients have, Dr. Lipscombe said more than 90 per cent of diabetics have Type 2, formerly known as adult-onset diabetes.
The study, published in this week's issue of The Lancet, also found that diabetes is afflicting more and more younger adults.
For people aged 20 to 49, incidence almost doubled between 1995 and 2005, to 3.5 per cent from 1.8 per cent. Among those 50 and older, rates jumped to 17.1 per cent from 10.6 per cent over the same period.
“So the absolute numbers are still greater in older people, but the concerning thing is that young people are increasing much more quickly,” said Dr. Lipscombe, an endocrinologist at Women's College Hospital in Toronto.
One piece of good news the researchers found is that diabetics are living longer — the rate of death dropped by 25 per cent over the decade, she said, noting that the lower mortality rate is contributing somewhat to overall numbers.
“There has been a vast improvement in the management of diabetes over the last 10 years, so we know a lot more about what we can do to prevent diabetes complications and reduce deaths. People are using better drugs, more intensive management of blood sugar, so we think we're just doing a better job of taking care of people with diabetes.”
Still, the growing number of cases is cause for concern because of the burden the disease already places on the health-care system — and the predicted impact in the future.
The epidemic of diabetes is being fuelled by a number of factors, but chief among them is obesity, said Dr. Stewart Harris, a spokesman for the Canadian Diabetes Association. In fact, many people now dub the co-epidemic “diabesity.”
“The bottom line is what's driving this dramatic increase in the number of people diagnosed with diabetes, particularly at a younger age, is the underlying obesity rates,” Dr. Harris, a family physician who treats many diabetics, said Thursday from London, Ont.
Despite public awareness campaigns promoting low-fat diets and regular exercise, many people continue with unhealthy lifestyles that contribute to being overweight — and hence to diabetes.
Dr. Harris said today's technology is also promoting higher “diabesity” rates among both children and adults, because they end up spending too much time in front of computer and TV screens.
“And it's not just what you're not doing by being there, it's what you're doing when you're in front of the TV. You tend to eat unhealthy food choices, you snack and you don't do physical activity,” he said.
“You don't even have to get off the couch to change the TV channel — there's a remote. The only muscles getting exercise now are your thumb muscles and your mouth.”
But for too many people, acknowledged Dr. Harris, healthy living isn't always an option because of insufficient income. Lean meats and fresh fruits and vegetables are usually more expensive than higher-fat and processed convenience foods.
Mary Ellen Wright, who was diagnosed with Type 2 diabetes in 2002, said she tries to eat a good diet but can't always afford to buy the healthiest foods.
Managing her sugar levels is also a challenge because the single mother of three from St. John's, N.L., must pay the full cost of her insulin, needles and glucose test strips out of her own pocket. The province does not provide insurance coverage for diabetes control and she has no drug plan from her “well-under $40,000-a-year” job.
“The biggest problem, and I think a lot of people find this, are the supplies,” Ms. Wright, 49, said from St. John's. “You try to budget and maintain a healthy diet. If I were not working and I was on social assistance, I would be able to access those things.”
“I afford the medications because I must, but they're not really being all that effective because I'm not monitoring my blood sugar the way I should be. I'm skimping on the needles and squeezing the last little bit out of the vial of insulin.”
“I think if I were able to test better I would have a better handle on my diabetes.”
Dr. Harris said diabetes puts individuals at a higher risk for heart attack and stroke, as well as for blindness, limb amputation and kidney failure.
“So this has a huge potential impact on our health-care system and our society, particularly when you look at the relatively young age when people are developing diabetes.... We're looking at 40 to 50 years potentially for health-care costs and management of diabetes-related risk factors and complications.
Dr. Lipscombe said the study should be a wake-up call for society, government and health planners.
“I think we need to make people aware that the risk is very real and it's increasing and that a very large segment of the population is at risk for diabetes at this point.”
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And apparently it's only getting worse. Crazytown!
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