Alberta’s Diabetes Landscape Jeffrey A. Johnson School of Public Health University of Alberta

Diabetes in Alberta By the numbers…. Almost 193,000 people were living with diabetes in Alberta in 2008. Over 17,000 new cases were identified in 2008. Diabetes rates have almost doubled over the past decade. Each year, adults with diabetes see physicians 2-3 times more often and spend almost 3 more days in hospital compared to their non-diabetic counterparts. People with diabetes are 2 times as likely to die than people without diabetes. Pulling all of the numbers together for the whole province takes a long time, so our actual counts are a year or two out of date.

Diabetes – what is it? Body has difficulty making insulin and/or using the insulin that they produce. Problematic because insulin is required to move glucose into cells so that it can be used by body tissues and organs.

Cardiovascular Disease Diabetes – what is it? 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. Diabetic Eye Disease Kidney Disease Cardiovascular Disease

Type 1 Diabetes Usually occurs early in life during childhood or adolescence and requires insulin injections. One of the most common chronic conditions in children Accounts for about 5% of all diabetes cases in the entire population.

Type 2 Diabetes Historically associated with onset after 40 years of age; however during the past decade, it has become much more common in younger individuals. Strongly associated with lifestyle factors, including physical inactivity, overweight and obesity. Accounts for about 95% of all diabetes cases in the entire population. Associated with many complications such as heart problems, kidney problems, eye disease etc.

Diabetes, It’s Complicated, …

Diabetes - Big Picture, Big Burden Is a chronic disease affecting more than 6% of adult Canadians. Healthcare costs of patients with diabetes are projected to be in excess of $800 million in Alberta. As people are getting diabetes earlier in life, they are also getting complications earlier in life.

Recognizing the growing burden of diabetes, Alberta Health and Wellness, like other provinces, developed plans to deal with it – the Alberta Diabetes Strategy was released in 2003, and has guided policies and programs for the province focused on diabetes. From this strategy, the province established the ADSS.

Alberta Diabetes Atlas 2009 1. Background and Methods 2. Epidemiological Trends 3. Children and Adolescents 4. Health Care Utilization 5. Cardiovascular Disease 6. Foot Disease and Lower Limb Amputations 7. Kidney Disease 8. Eye Disease 9. Mental Health Disorders 10. Status Aboriginal Population 11. Key Findings and Policy Options

Interactive Website www.albertadiabetes.ca

Number of Albertans Living with Diabetes 1995-2008

Newly Identified Cases of Diabetes 1995-2008

Rate of Diabetes in Alberta, 1995-2008 Age-adjusted Rate increase=57% over time period (1995-2008)

Age-Specific Diabetes Rates, 2007 DO NOT HAVE UPDATED 2008 DATA OUTPUT, YET.

Alberta Diabetes Prevalence Map: 2007 data Figure: 2008 data Age-Adjusted Diabetes Prevalence Rates by Zone, 2008 Provincial rate = 5.5%

Death Rates in Alberta 1995 - 2008 ADJUSTED FOR AGE.

Diabetes and Special Populations

Diabetes in Children and Adolescents by Zone 2007 data

Diabetes Prevalence, 1995-2008 Children and Adolescents 30% 45% 52% 64%

Diabetes in Alberta Almost 193,000 Albertans living with diabetes. Over 1,700 new cases each month. It is mostly a condition of older adults, but we are seeing increasing numbers in children and adolescents. Of increasing concern is the health care services needed for this growing population!

Diabetes & Heart Disease 1995-2008 (Rate) Represents ACS (acute MI and unstable angina). Rates are age-adjusted.

Diabetes & Heart Disease 1995-2008 (Number of People) Represents ACS (acute MI and unstable angina) – number of cases

Diabetes & Eye Disease Eye Examinations* We are limited in this surveillance as visits to optometrists for eye examinations is not reliably captured in the fee-for-service system, so we are only able to report on eye examinations by ophthalmologists. * Eye examinations by an Ophthalmologist

Diabetes & Health Care Services… People with diabetes see GPs and Specialists 2 to 3 times more often than people without diabetes Access to care and cost of care are important considerations. Heart Disease is a major driver for health care costs In general, we see underuse of many recommended preventive care services in the system.

Diabetes What can we do?

The ABC’s of Diabetes If you have diabetes A: A1C (average of blood sugars over the past three months) B: Blood Pressure Control C: Cholesterol Healthy Weight Physical activity Waist size Regular foot exams Yearly eye exam Stop smoking

Preventing Diabetes If you don’t have diabetes Healthy Weight Physical Activity Be active! Walking, gardening, water aerobics etc. Healthy Diet High in Fruits and Vegetables Low in Fat, High in Fiber Low in Carbohydrates Yearly physician visits Stop smoking

Stay Healthy!