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%.

More Myths of Diabetes

Diabetes affects the young and old, rich and poor, from cultures all across the world. The World Health Organization preaches how diabetes has increasingly become a lifestyle-related disease. Awareness is an important part of the process working towards a solution to stem the growing prevalence.

Here are a few more common diabetes-related factoids. Which are true and which are simply myths?

Myth: Type 2 diabetes only occurs in adults

The truth: At one time, type 2 diabetes was called adult onset diabetes. More and more however, children are being diagnosed with type 2. This is likely as a result of poor diet and lack of exercise.

Myth: Gestational diabetes only affects pregnant women

The truth: This is absolutely true. Gestational diabetes occurs during pregnancy and goes away after pregnancy. Women who have gestational diabetes have a higher risk for developing type 2 diabetes later in life. 

Myth: Diabetes is not a serious disease like cancer or heart disease. 

The truth: Diabetes is very serious. It can lead to heart disease, stroke, blindness or amputations. Diabetes is one of the leading causes of death in Canada.

Click here to visit Part 1 of our blog on Myths of Diabetes

Myths of Diabetes

Diabetes affects the young and old, rich and poor, from cultures all across the world. The World Health Organization preaches how diabetes has increasingly become a lifestyle-related disease. Awareness is an important part of the process working towards a solution to stem the growing prevalence.

While any discussion on the topic can be seen as a positive step towards changing people's lifestyles, misinformation often leads to the spread of unproductive myths. Take a look below at some common myths of diabetes and learn which tips are valuable and which ones need to be reeled in.

Myth: Eating too much sugar causes diabetes

The truth: Not really but consuming a lot of sugar can have an impact.

Type 1 diabetes is caused by genetics and unknown factors that trigger the onset. Type 2 is caused by genetics and lifestyle.

Being overweight increases the risk of developing diabetes and a high-calorie diet contributes to weight gain. Research shows that drinking sugary drinks is linked to type 2 diabetes. 

Myth: People who have diabetes are more likely to catch colds and other illnesses.

The truth: People with diabetes are no more likely to catch colds or other viruses than anyone else. However, having any type of illness can make diabetes more difficult to control. It's recommended that people who have diabetes get a flu shot each year.

Myth: If your doctor tells you need to start using insulin to control your type 2 diabetes, it means you're not managing your diabetes properly. 

The truth: For the most part, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level just by using oral medications. But over time, the body produces less insulin and as a result, oral medications may not be enough.

In everyday language, what is diabetes?

Having diabetes means the body makes little or no insulin and/or the body doesn’t properly use the insulin it makes. The body gets energy by converting carbohydrates into sugar (glucose). The body needs insulin to make the glucose.

Essentially...

No insulin = no glucose = no energy to the brain.

It’s complicated, but simply put:

Healthy Pancreas

Type 1 Diabetes – makes up 10% of cases

• In most cases, you’re born with it
• Pancreas makes little or no insulin
• Occurs most often in children and young adults

Type 2 Diabetes – makes up 90% of cases

• Impacted by genetics and lifestyle
• Insulin resistance and/or pancreas not working properly
• Occurs most often in adults

Will Canada avoid the diabetes epidemic?

Type 2 diabetes is one of the fastest growing diseases in Canada with more than 60,000 new cases each year. The Canadian Diabetes Association says more than 1.8 million Canadians are currently diagnosed with diabetes and that the disease can shorten life expectancy by 5 to 15 years. 

Beyond the obvious health issues, diabetes is costing Canadians. According to Canada’s Diabetic Cost Model, the economic burden of the disease was over $12B in 2010. This amount could increase to $17B by 2020 if left unchecked. 

But it’s not all bad. 

Research shows that lifestyle changes can help prevent or delay the onset of type 2 diabetes. Healthy eating, weight control and physical activity are important prevention steps. In fact, in some cases, type 2 diabetes can be controlled by diet and exercise.

As with any medical condition, being well informed is an important first step. Stay tuned for our weekly posts on diabetes facts.

Brand Name Drugs vs Generic - Part II

What generic drugs mean to business (not just a benefits plan)

The recent National Post article on generic drugs is a topical reminder on the issue of generics, brand names and cost management.   

Generic vs Brand Name drugs

Who says generics and brand name drugs are the same?

Luckily, there’s an independent body that validates whether a generic and a brand name drug are the same - Health Canada. See Health Canada regulates the effectiveness of generic medications. Their regulations are complex and rigorous but ultimately, tests are in place to ensure the generic version of a drug works the same as the brand name for the vast majority of people. 

The Need for Industry Pooling on High Cost Drug Claims

The high cost drug landscape

Over the past decade, on average, prescription drug plan costs have increased between 9-12% each year. These increases have largely been driven by blockbuster drugs such as Lipitor and Crestor.  However, the face of the prescription drug landscape is changing.  Recently, cost increases have slowed due to drugs coming off patent and legislative changes to generic drug prices. Meanwhile the cost and claiming frequency of high cost biologic drugs continues to increase.  

In fact, according to our 2010 data, the total annual cost associated with specialty medications was 97% of the total annual cost of acute medications (such as antibiotics). Based on our figures, the average annual cost per claimant for specialty medications claims is over 136 times higher!

Medical advances have led to a significant increase in the number of high cost prescription drug therapies.  Although their annual costs can be considerable (sometimes well over $50,000 per year), these medications are often life-changing. 

Forecasted growth in the number of high cost drugs available and prescribed in the Canadian market is causing concern among plan sponsors and insurers. This scenario could result in strain for both the plan sponsor trying to control the rising cost of a renewal, and the plan member who may be facing a reduction in coverage of his or her drug therapy.  Given the life-changing nature of these blockbuster drugs, we believe the best approach to managing these costs is the combination of a strong prior authorization process and a mechanism to spread the potential costs across the industry.

The industry solution

Canadian life and health insurers have come together to offer a new drug pooling framework, designed to help protect private benefits plans from the impact of high cost drugs.