Abstract
Diabetes mellitus is a major risk factor for heart disease (heart attack, angina, and heart failure), stroke, and hypertension, which shorten the average life expectancy. The main objective of this study was to describe the prevalence of heart disease, hypertension, and stroke among Canadians with diabetes compared to those without diabetes in the Canadian general population aged 12 years and over. It also estimated the strength of association between diabetes, heart disease, hypertension, and other factors such as age, gender, cigarette smoking, alcohol drinking, education status, body mass index (BMI), and other socioeconomic factors. Descriptive statistics were used initially to estimate the prevalence of related comorbidities by age and gender. Logistic regression was then employed to determine the potential strength of association between various effects. Data included 127,610 individuals who participated in the 2.1 cycles of the Canadian Community Health Survey (CCHS) in 2002–2003. The prevalence of self-reported hypertension, heart disease, and stroke among individuals with diabetes were 51.9, 21.7, and 4.8%, respectively. By comparison, prevalence among those without diabetes was 12.7, 4.2, and 0.9%. Adjusted Odds Ratios (OR) were 4.15, 5.04, and 6.75 for males, and 4.10, 5.29, and 4.56 for females hypertension, heart disease, and stroke, respectively. Lower income (OR from 1.27—1.94) and lower education (OR from 1.23—1.86) were independently associated with a high prevalence of hypertension, heart disease, and stroke among diabetics. Alcohol consumption (OR from 1.06—1.38), high BMI (OR from 1.17—1.40), physical inactivity (OR from 1.21—2.45), ethnicity, and immigration status were also strongly associated with hypertension, heart disease, and stroke. The adjusted prevalence of hypertension, heart disease, and stroke in the CCHS-2003 health survey in Canada was significantly higher among those with diabetes compared to those without. Other factors such as age, gender, BMI, lifestyle, family incomes, physical activity levels, and socioeconomic status also affected the strength of association between diabetes and resulting comorbidities.
Highlights
Diabetes mellitus is the seventh leading cause of death in Canada, affects more than 2 million Canadians, and may shorten life expectancy by up to 15 years[1,2]
The adjusted prevalence of hypertension, heart disease, and stroke in the Canadian Community Health Survey (CCHS)-2003 health survey in Canada was significantly higher among those with diabetes compared to those without. Other factors such as age, gender, body mass index (BMI), lifestyle, family incomes, physical activity levels, and socioeconomic status affected the strength of association between diabetes and resulting comorbidities
The overall prevalence of self-reported diabetes mellitus in the CCHS-2003 cohort was 4.9% for males and 4.3% for females (Table 1), and the risk of diabetes was higher among males than females (Table 2)
Summary
Diabetes mellitus is the seventh leading cause of death in Canada, affects more than 2 million Canadians, and may shorten life expectancy by up to 15 years[1,2]. Direct medical costs of managing complications from diabetes average $47,240 per patient over 30 years (in 2000 U.S dollars)[7]. More severe or debilitating events generate a greater financial burden than do early-stage complications and complications that are initially relatively low in cost can progress to more costly advanced stages[8]. This significant reduction of life span and quality of life, along with the financial costs of diabetes, suggest that action is required for prevention and control of complications of diabetes[1]
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