Abstract
Health IssueDiabetes mellitus (DM) is a chronic health condition affecting 4.8% of Canadian adults ≥ 20 years of age. The prevalence increases with age. According to the National Diabetes Surveillance System (NDSS) (1998–1999), approximately 12% of Canadians aged 60–74 years are affected. One-third of cases may remain undiagnosed. The projected increase in DM prevalence largely results from rising rates of obesity and inactivity.Key FindingsDM in Canada appears to be more common among men than women. However, among Aboriginal Canadians, two-thirds of affected individuals are women. Although obesity is more prevalent among men than women (35% vs. 27%), the DM risk associated with obesity is greater for women. Socio-economic status is inversely related to DM prevalence but the income-related disparities are greater among women. Polycystic ovarian syndrome affects 5–7% of reproductive-aged women and doubles their risk for DM. Women with gestational diabetes frequently develop DM over the next 10 years.Data Gaps and RecommendationsStudies of at risk ethnic/racial groups and women with gestational diabetes are needed. Age and culturally sensitive programs need to be developed and evaluated. Studies of low-income diabetic women are required before determining potential interventions. Lifestyle programs in schools and workplaces are needed to promote well-being and combat obesity/inactivity, together with lobbying of the food industry for needed changes. High depression rates among diabetic women influence self-care ability and health care expenditures. Health professionals need further training in the use of effective counseling skills that will assist people with DM to make and maintain difficult behavioural changes.
Highlights
Diabetes is a major cause of heart disease, blindness, kidney failure and limb amputations in Canada and contributes a huge economic cost to the Canadian health care system
Prevalence The 1996–1997 National Population Health Survey (NPHS) revealed a prevalence of self-reported, diagnosed Diabetes mellitus (DM) of 3.2% among Canadians aged 12 and over; the overall prevalence was estimated at 4.9%, including undiagnosed cases of DM. [7,8] The 2000 Canadian Community Health Survey (CCHS) found rates of self-reported, diagnosed diabetes that corresponded to an overall prevalence of 4.2% (Figure 1)
The National Diabetes Surveillance System (NDSS) estimates that approximately 1.7 million Canadians had DM in 1998–1999
Summary
Diabetes is a major cause of heart disease, blindness, kidney failure and limb amputations in Canada and contributes a huge economic cost to the Canadian health care system. The National Diabetes Surveillance System (NDSS) estimates that 4.8% of Canadians (1.13 million) aged 20 years and older in the participating provinces had physician-diagnosed diabetes in 1998–1999. The number of people with diabetes mellitus (DM) is projected to increase substantially over the 20 years, largely as a result of increases in rates of obesity and inactivity, as well as the aging of the population. Native Canadians have a threefold increased risk of impaired glucose tolerance (IGT) and type 2 DM, Aboriginal women being vulnerable. BMC Women's Health 2004, 4:S16 http://www.biomedcentral.com/1472-6874/4/S1/S16 groups that are at increased risk of developing DM include South Asians, Orientals, African Canadians and Hispanics. Further research is needed to determine the cultural groups affected and the other important determinants of health in these women of low socio-economic status
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