New Diabetes Guidelines Released

At your next visit to the doctor, you may find a new testing approach and new diagnostic criteria in place for diabetes and prediabetes.

Guidelines released earlier this month by the Canadian Diabetes Association include a recommendation for use of the A1C blood test. This test provides a single, practical measure of average blood glucose with no need for 12-hour fasting.

As well, diabetes will now be diagnosed at different blood glucose levels. Those with an A1C level of 6.5 per cent or greater will be diagnosed with diabetes, while those with an A1C level of 6.0-6.4 per cent will be diagnosed with prediabetes.

Screening for type 2 diabetes is recommended every 3 years for all Canadians over 40, or earlier and more frequently for those with risk factors. 

For Canadians already diagnosed with diabetes, the guidelines encourage knowledge of the heart health ABCDEs:

• A – A1C in optimal range
• B – Blood pressure optimally controlled
• C – Cholesterol in target range
• D – Drugs – heart-protecting medications for the right patients
• E – Exercise and other lifestyle measures
• S – Stop smoking 

New interactive tools for assessment and management of diabetes are available at http://guidelines.diabetes.ca, along with the full text of the new guidelines.

Diabetes – The Burden in Canada

While diabetes can take a serious toll on a person’s health, it also carries a heavy financial burden.

The Canadian Diabetes Association estimates that by 2020, diabetes will cost the Canadian health care system $16 billion a year. People with diabetes incur medical costs that are two to three times higher than non-diabetics. A person with diabetes can face costs for medication and supplies ranging from $1,000 to $15,000 a year.

Although diabetes has traditionally been thought of as an older person’s disease, more than 50% of Canadians diagnosed with diabetes are of working age – between 25 and 64 years old – according to the Public Health Agency of Canada. As a result, diabetes rates also have an impact on employee absence, disability and benefit plan costs.

The greatest relative increase in diabetes rates is seen in the 35-to-39 and 40-to-44-year-old age groups. This increase in younger age groups is, in part, likely due to growing levels of overweight and obesity. Adults who are obese are two to four times more likely to have type 2 diabetes.

Diabetes – Prevalence and Prevention

Today, about 3 million Canadians live with diabetes. The Canadian Diabetes Association estimates another 6 million are prediabetic.

The number of Canadians with type 2 diabetes is growing dramatically for a few reasons:

• The population is aging.
• Obesity is on the rise.
• Canadian lifestyles are more sedentary.
• Aboriginal people are three to five times more likely than the general population to develop type 2 diabetes.
• Almost 80% of new Canadians come from populations that are at higher risk for type 2 diabetes. These include people of Aboriginal, Hispanic, Asian, South Asian and African descent.

So what’s prediabetes?

Prediabetes is identified when the blood glucose is above normal, but not high enough to be considered diabetes.

Exercise, along with healthy eating and weight loss, can prevent or delay the onset of type 2 diabetes. In one large study, people at risk of type 2 diabetes reduced their risk by 58% by exercising moderately for 30 minutes a day and losing just 5 to 7 per cent of their body weight. In people age 60 and older, the risk was cut by almost 71%.