October 2005

Information

Integrated Strategy on Healthy Living and Chronic Disease

Diabetes

Under the Integrated Strategy on Healthy Living and Chronic Disease, funding to enhance the Canadian Diabetes Strategy (CDS) will total $90 million over five years ($18 million per year of ongoing funding).

Approximately 1.8 million Canadians live with diabetes, and one in three individuals with diabetes is unaware that he or she has the disease. Diabetes affects all ages, and the proportion of the Canadian population who reported having type 2 diabetes increased by 27% between 1994 and 2000. As the Canadian population ages and rates of obesity rise, this trend is expected to continue.

If left untreated or improperly managed over time, diabetes can result in a variety of complications including heart disease and stroke, kidney disease, vision loss, impotence, amputations and nerve damage. The best way to avoid the onset of these complications is to address risk factors such as obesity, unhealthy eating and physical inactivity. For individuals with diabetes, complications can be avoided, reduced and delayed through prompt identification and effective management of the disease.

Addressing Diabetes

The Canadian Diabetes Strategy has been a program of the Government of Canada since 1999. Three program components - prevention and promotion, surveillance and national coordination - were originally led by Health Canada, and are now led by the Public Health Agency of Canada. To date, the CDS has laid a foundation for moving forward on diabetes by:

• raising awareness of the disease and its risk factors;
• creating the first Canadian surveillance system for a chronic disease that is based on provincial and territorial health administration data; and
• bringing together stakeholders, communities, provinces and territories to develop national strategic objectives for addressing diabetes.

Under the enhanced CDS, a significant new direction will be followed, targeting populations who are at higher risk of developing diabetes, especially those who are overweight, are obese or have pre-diabetes, which is a condition where blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. Other target populations will include individuals who are over age 40; who have high blood pressure and high levels of cholesterol or other fats in the blood; who have a family history of diabetes; or who are of certain high-risk ethnic populations.

The enhanced CDS will form the federal government's contribution toward a national diabetes strategy. It will be informed by the strategic framework which was developed by federal, provincial and territorial experts, as well as stakeholders. The enhanced CDS is designed around the following elements:

• National Diabetes Surveillance System: This system was developed to provide surveillance information concerning diabetes at provincial, territorial and national levels. In collaboration with provinces, territories and Aboriginal partners, the Public Health Agency of Canada will support enhancements to this system such as reporting information on type 1 diabetes, as well as on the burden of diabetes on Aboriginal people in Canada. This system also provides a foundation to support surveillance for other chronic diseases such as cardiovascular disease.

• Knowledge Development and Exchange for Diabetes Prevention and Management: Research and evidence provide the basis for understanding the causes of diabetes, as well as its prevention, effective management and cure. Knowledge Development and Exchange will include strategies to translate science-based research into effective policies and programs, including tools for practitioners such as clinical practice guidelines related to diabetes.

• Diabetes Community-Based Promotion and Programming: Community-based programs can substantially promote a positive shift in health status in high-risk populations. These projects will be tailored to the particular needs of communities, taking into account factors including cultural and ethnic diversity, demographics, and other existing high-risk conditions such as obesity and physical inactivity.

• Diabetes Public Information: Targeted primary prevention is critical for preventing diabetes or delaying the onset of type 2 diabetes in susceptible individuals or populations. This will be achieved by furthering awareness of the importance of prevention and early detection of diabetes; increasing integration of messages with non-governmental organizations, public health units and other health-delivery partners; and raising awareness and knowledge of conditions and risk factors for diabetes.

• Diabetes Coordination: This element of the Canadian Diabetes Strategy will support and promote national collaboration and coordination, both within the federal government and with diabetes partners including provinces, territories and stakeholders, in order to maximize effectiveness.

Although not part of the Integrated Strategy, funding for the Aboriginal Diabetes Initiative will be increased to $25 million in the first year, growing to $55 million at maturity, as part of the Aboriginal health package announced in Budget 2005. The Aboriginal Diabetes Initiative provides care and treatment for First Nations on-reserve and Inuit communities, as well as culturally-appropriate prevention, education and lifestyle supports for all Aboriginal people.

Working Together

In addition to federal initiatives, all provinces and territories are taking action on diabetes. Similarly, non-governmental organizations with an interest in diabetes have developed their own approaches.

Through the Canadian Institutes of Health Research, the Government of Canada has invested close to $6 million for research on type 1 diabetes research and $12 million on type 2 diabetes in 2004-05. During the same year, diabetes research funding - including research that is more broadly applicable to diabetes - totalled just over $30 million. As well, the Canada Foundation for Innovation has been supporting diabetes research infrastructure across Canada, with investments of about $27 million since 1997.

The Government of Canada recognizes the social and economic strains caused by diabetes and is committed to cooperating with its partners, including non-governmental organizations and provincial and territorial governments.