1. Alberta’s Diabetes Landscape Jeffrey A. Johnson
School of Public Health
University of Alberta

2. Diabetes in Alberta By the numbers….
Almost 193,000 people were living with diabetes in Alberta in 2008.
Over 17,000 new cases were identified in 2008.
Diabetes rates have almost doubled over the past decade.
Each year, adults with diabetes see physicians times more often and spend almost 3 more days in hospital compared to their non-diabetic counterparts.
People with diabetes are 2 times as likely to die than people without diabetes.
Pulling all of the numbers together for the whole province takes a long time, so our actual counts are a year or two out of date.

3. Diabetes – what is it?
Body has difficulty making insulin and/or using the insulin that they produce.
Problematic because insulin is required to move glucose into cells so that it can be used by body tissues and organs.

4. Cardiovascular Disease
Diabetes – what is it?
When glucose remains in the blood, blood glucose levels can rise to dangerously high levels and result in acute complications.
Higher than normal blood glucose levels also can result in long- term organ damage and affect the eyes, kidneys and cardiovascular system.
Diabetic Eye Disease
Kidney Disease
Cardiovascular Disease

5. Type 1 Diabetes
Usually occurs early in life during childhood or adolescence and requires insulin injections.
One of the most common chronic conditions in children
Accounts for about 5% of all diabetes cases in the entire population.

6. Type 2 Diabetes
Historically associated with onset after 40 years of age; however during the past decade, it has become much more common in younger individuals.
Strongly associated with lifestyle factors, including physical inactivity, overweight and obesity.
Accounts for about 95% of all diabetes cases in the entire population.
Associated with many complications such as heart problems, kidney problems, eye disease etc.

7. Diabetes, It’s Complicated, …

8. Diabetes - Big Picture, Big Burden
Is a chronic disease affecting more than 6% of adult Canadians.
Healthcare costs of patients with diabetes are projected to be in excess of $800 million in Alberta.
As people are getting diabetes earlier in life, they are also getting complications earlier in life.

9. Recognizing the growing burden of diabetes, Alberta Health and Wellness, like other provinces, developed plans to deal with it – the Alberta Diabetes Strategy was released in 2003, and has guided policies and programs for the province focused on diabetes. From this strategy, the province established the ADSS.

10. Alberta Diabetes Atlas 2009
1. Background and Methods
2. Epidemiological Trends
3. Children and Adolescents
4. Health Care Utilization
5. Cardiovascular Disease
6. Foot Disease and Lower Limb Amputations
7. Kidney Disease
8. Eye Disease
9. Mental Health Disorders
10. Status Aboriginal Population
11. Key Findings and Policy Options

11. Interactive Website

12. Number of Albertans Living with Diabetes 1995-2008

13. Newly Identified Cases of Diabetes 1995-2008

14. Rate of Diabetes in Alberta, 1995-2008
Age-adjusted
Rate increase=57% over time period ( )

15. Age-Specific Diabetes Rates, 2007
DO NOT HAVE UPDATED 2008 DATA OUTPUT, YET.

16. Alberta Diabetes Prevalence
Map: 2007 data
Figure: 2008 data Age-Adjusted Diabetes Prevalence Rates by Zone, 2008
Provincial rate = 5.5%

17. Death Rates in Alberta 1995 - 2008
ADJUSTED FOR AGE.

18. Diabetes and Special Populations

19. Diabetes in Children and Adolescents by Zone
2007 data

20. Diabetes Prevalence, 1995-2008 Children and Adolescents
30%
45%
52%
64%

21. Diabetes in Alberta Almost 193,000 Albertans living with diabetes.
Over 1,700 new cases each month.
It is mostly a condition of older adults, but we are seeing increasing numbers in children and adolescents.
Of increasing concern is the health care services needed for this growing population!

22. Diabetes & Heart Disease 1995-2008 (Rate)
Represents ACS (acute MI and unstable angina). Rates are age-adjusted.

23. Diabetes & Heart Disease 1995-2008 (Number of People)
Represents ACS (acute MI and unstable angina) – number of cases

24. Diabetes & Eye Disease Eye Examinations*
We are limited in this surveillance as visits to optometrists for eye examinations is not reliably captured in the fee-for-service system, so we are only able to report on eye examinations by ophthalmologists.
* Eye examinations by an Ophthalmologist

25. Diabetes & Health Care Services…
People with diabetes see GPs and Specialists 2 to 3 times more often than people without diabetes
Access to care and cost of care are important considerations.
Heart Disease is a major driver for health care costs
In general, we see underuse of many recommended preventive care services in the system.

26. Diabetes What can we do?

27. The ABC’s of Diabetes If you have diabetes
A: A1C (average of blood sugars over the past three months)
B: Blood Pressure Control
C: Cholesterol
Healthy Weight
Physical activity
Waist size
Regular foot exams
Yearly eye exam
Stop smoking

28. Preventing Diabetes If you don’t have diabetes Healthy Weight
Physical Activity
Be active! Walking, gardening, water aerobics etc.
Healthy Diet
High in Fruits and Vegetables
Low in Fat, High in Fiber
Low in Carbohydrates
Yearly physician visits
Stop smoking

29. Stay Healthy!