Canadians are getting fatter and getting older.
Those two trends are converging to unleash what is being called “an economic tsunami” triggered by the soaring incidence of diabetes.
A report commissioned by the Canadian Diabetes Association and issued last year estimated that in the past decade, the number of people with diabetes in Canada roughly doubled, to 2.5 million from 1.3 million. Over the next 10 years, that number is predicted to climb by another 1.2 million.
In B.C., the rate of increase is even greater. So while British Columbians are generally healthier than most other Canadians based on a number of indicators, by 2020, we are expected to have the second highest incidence of diabetes in the country.
The incidence of diabetes is now slightly lower than the national average, but that is expected to change because of the way B.C.’s population is evolving. We are aging, as are Canadians in the rest of the country, and diabetes is a disease that becomes more prevalent as we grow older.
But because of hereditary and dietary factors, some subsets of the Canadian population are more likely than others to get diabetes. First nations and people of Asian and southeast Asian descent are prone to diabetes, and those groups are growing as a percentage of our overall population.
The CDA says that about 70 per cent of that growth is locked in; it can’t be prevented. But that still leaves plenty of room for both slowing the onset of diabetes and limiting the damage it causes to personal health, to our health care system and to our economy through lost productivity.
That’s because as with many diseases, diet and exercise play a big role.
Sugar is an important part of the diabetes story, in part because of what it is not.
Despite persistent mythology to the contrary, what it is not is a cause of diabetes.
But it is an important contributing factor in a disease that is already costing British Columbians an estimated $1.3 billion a year because of the way diet plays such an important role.
The confusion over the role of sugar in diabetes may come from the nature of the disease. Diabetes is a chronic condition that can be serious or fatal. It occurs when the body cannot produce enough insulin or is unable to take advantage of the insulin it produces.
We need insulin to regulate the amount of sugar in our blood, both to allow it to be processed for energy and to prevent dangerously high levels of blood sugar.
There are three types of diabetes.
Type 1 usually develops in childhood or adolescence. People with Type 1 diabetes, also known as juvenile diabetes, must have regular insulin injections in addition to paying attention to their diet and getting enough exercise. There is no cure.
Type 2, which affects 90 per cent of people who get diabetes, usually comes on later in life. Again, there is no cure, but it can be controlled through careful attention to diet and exercise, some medications and insulin.
The third type, gestational diabetes, occurs during a small percentage of pregnancies and can affect the health of mother and child and make them more likely to experience Type 2 diabetes later in life.
Obesity is an important risk factor, but straying even a few extra kilograms beyond slim and trim can inflict significant harm.
Glen Doucet, vice-president of public policy for the Canadian Diabetes Association, says you don’t have to be clinically obese to be at increased risk of developing the disease, or, if you already have it, of developing serious complications such as circulation problems and amputations, heart disease and strokes, blindness and kidney failure.
At the same time, a healthy body weight doesn’t guarantee that someone who is predisposed to the disease won’t develop diabetes as a serious or even fatal illness. But sticking to a healthy weight and exercising is still considered to be the most useful thing people can do to help themselves and to soften the blow we know is coming for our health care stem.
“I think our emphasis in British Columbia and indeed across Canada needs to be on secondary prevention. Really preventing folks with pre-diabetes and diabetes from developing those serious complications that drive up health care costs and mortality and really cause significant economic impact,” says Doucet.
Laying off the sugar will help.