A framework for a comprehensive national diabetes strategy with a goal of turning the tide on the rampant and increasing rate of diabetes in Canada.
A Pan-Canadian Diabetes Strategy
JDRF Canada Supports Diabetes 360⁰
JDRF Canada is supporting the Diabetes 360⁰ initiative, a framework for a pan-Canadian diabetes strategy which would be led by the Government of Canada in collaboration with provincial and territorial governments and diabetes organizations. Diabetes 360⁰ was conceived by Diabetes Canada and developed in collaboration with 120 experts. Supported by Canada’s leading diabetes organizations Diabetes 360⁰ aims to drastically reduce and eventually end diabetes based on four targets:
- 90% of Canadians live in an environment that prevents the development of diabetes
- 90% of Canadians are aware of their diabetes status
- 90% of Canadians living with prediabetes or diabetes are engaged in appropriate interventions to prevent diabetes and its complications
- 90% of Canadians engaged in interventions are achieving improved health outcomes
That the government implement a national diabetes strategy (Diabetes 360⁰) with specific outcomes for type 1 diabetes and include new funding for research aimed at curing, preventing and treating the disease.
The Government of Canada has the chance to play a critical leadership role alongside provincial, territorial and municipal partners and diabetes stakeholders in supporting the Diabetes 360⁰ initiative to develop a pan-Canadian strategy for diabetes. Type 1 and type 2 diabetes are very different diseases and will require different approaches within any national strategy. Many of the lifestyle interventions aimed at preventing type 2 diabetes will have no impact on type 1, a non-preventable autoimmune disease for which there is no known cure. For T1D, prevention means focusing on research to understand what triggers the destruction of the body’s insulin producing cells.
Diabetes in Canada
Since 2013, Canada has been without a strategy to address one of the most significant health-care crisis of our time. With no dedicated support or action to tackle the diabetes epidemic, it means that, every 24 hours:
- More than 20 Canadians die of diabetes-related complications
- 480 more Canadians are diagnosed with this devastating disease
- 14 Canadians have a lower limb amputation
- And our health care system spends $75 million treating diabetes
Diabetes prevalence in Canada is not only skyrocketing, but is already among the worst of OECD countries (Organization for Economic Co-operation and Development), according to the International Diabetes Federation. In Canada today, one in three people lives with prediabetes or diabetes – 11 million Canadians. Since 2000, the number of Canadians with diabetes has doubled. A 20-year-old in Canada now has a 50 per cent chance of developing the disease and this grows to 80 per cent within some Indigenous populations. The global rate of T1D is climbing by 3% every year – with Canada’s rate growing higher at 5% – and we don’t know why. Beyond the immeasurable impact on human life, if prevalence grows by 40 per cent in the next decade as projected, the direct costs associated with treating diabetes in Canada will top $39 billion by 2028.
For T1D, prevention means an increased investment in autoimmunity research to understand and prevent the response that triggers the body’s destruction of its insulin-producing cells.
Delayed diagnosis of T1D is a leading factor in incidence of life-threatening but avoidable diabetic ketoacidosis (DKA) in both children and adults with an estimated 5-10K Canadians hospitalized annually due to DKA. An alarming number are infants in toddlers. Nearly 4 in 10 children under age 3 present with DKA at the time of first diagnosis. Of these, 38% had visited a physician within the previous week. Interventions are needed to help Health Care Providers diagnose T1D earlier, including increased use of finger-prick blood glucose testing in clinical settings and testing of family members of those with T1D.
Appropriate interventions for T1D aimed at reducing complications include those promoting adherence to recommended treatment guidelines (eye and foot checks, for example) as well as those that increase access to beneficial diabetes technologies such as insulin pumps, flash glucose monitoring, continuous glucose monitoring and hybrid-closed loop systems.
Improving outcomes with respect to T1D means moving beyond HbA1C to look at other metrics such as time spent in target range, and reduced incidences of hypo- and hyperglycemia.
Diabetes 360°: Framework for a National Diabetes Strategy
In the wake of a growing diabetes epidemic in Canada, Diabetes Canada convened a coalition of experts in health care, government, private sector and education from across Canada to develop a response to the urgent situation.
In 2018, Diabetes Canada released the report “Diabetes 360˚: A Framework for a Diabetes Strategy for Canada. Diabetes 360°. This strategy is a comprehensive approach to preventing, where possible, and managing diabetes in Canada with a goal of turning the tide on the rampant and increasing rate of diabetes in Canada.
Excerpt from the Report
The report’s primary recommendation calls for $150 million in funding over seven years to support the development and implementation of a new national diabetes strategy. A small investment compared to the projected $9 billion in savings in healthcare costs over the next seven years if a national approach is adopted. Even more important are the suggested benefits for those living with diabetes, with recommendations that focus on prevention (~110,000 cases per year), management (avoiding 35,000 hospitalizations each year), and reductions in the most feared complications – blindness (diabetic retinopathy) and lower-limb amputation.
The report also recommends taking a new approach to stemming the diabetes epidemic based on the proven model used for HIV/AIDS and other global disease strategies with clearly defined targets and outcomes.