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Report from the National Diabetes Surveillance System: Diabetes in Canada, 2009

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Other Health Problems

Individuals with diabetes often develop other diabetes-related health problems. Seven health problems are currently tracked by the NDSS: hypertension, ischemic heart disease, heart attack (acute myocardial infarction), heart failure, chronic kidney disease, stroke (cerebrovascular disease) and lower limb amputations. All but hypertension are tracked using hospitalization data.

People with diabetes may not always be hospitalized with these health problems, leading to underestimates. Therefore, the NDSS tracked hypertension and plans to track other health problems using physician billing and hospitalizations, similar to the method used to track diabetes.

The case criteria for hypertension were one or more hospitalizations or 2 or more physician claims within 2 years for hypertension.

  • AdultsFootnote 1 with diagnosed diabetes were diagnosed 3 times more often with hypertension than those without diabetes. The number of adults with diabetes who also had hypertension was 1,307,188. The proportion among people with diabetes was 63%.
  • AdultsFootnote 2 with diabetes were hospitalized with selected health problems significantly more often than their counterparts without diabetes with selected health problems (Table 3).
    • about 3 times more often with ischemic heart disease (93,691 adults) and with heart attack (a subset of ischemic heart disease (26,895 adults));
    • almost 4 times more often with heart failure (49,665 adults);
    • about 6 times more often with chronic kidney disease (40,341 adults);
    • almost 3 times more often with stroke (23,912 adults); and
    • almost 19 times more often with lower limb amputations (3,001 adults).
Table 3. Rate RatiosTable 1 - Footnote 1 Comparing Adults with Diabetes Hospitalized with Other Health ProblemsTable 1 - Footnote 2 to Those Without Diabetes, the Number of Adults with Diabetes Hospitalized with Other Health Problems and the Proportion Among Adults With Diabetes (Ranked Highest to Lowest), Canada,Table 1 - Footnote 3 2006-07
Other Health Problems Rate Ratios Adults with Diabetes Hospitalized with Other Health Problems Proportion (%) of All Adults with Diabetes

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of April 2009

Table 1 - Footnote 1
Data were rate ratios of age-standardized rates. Data from Quebec were not available for the rate ratio statistics, but were included in the number of adults with diabetes who had other health problems.
Table 1 - Footnote 2
Other Health Problems were: ischemic heart disease, heart attack (acute myocardial infarction) heart failure (myocardial infarction), chronic kidney disease, stroke (cebrovascular) and lower limb amputations A person with diabetes hospitalized with more than one health problem was counted once in each category.
Table 1 - Footnote 3
Data from Nunavut were unavailable.
Table 1 - Footnote 4
When more than one hospitalization is recorded in the heart attack category, an individual with diagnosed diabetes is counted only once under the broader ischemic heart disease category.
Ischaemic Heart Disease 3.5 93,691 4.5
Heart AttackTable 1 - Footnote 4 (Acute Myocardial Infarction) 3.3 26,895 1.3
Heart Failure 3.9 49,665 2.4
Chronic Kidney Disease 6.5 40,341 2.0
Stroke (Cerebrovascular Disease) 2.7 23,912 1.2
Lower Limb Amputations 18.6 3,001 0.2
Individuals With Diagnosed Diabetes   2,061,995 100.0

Table 3 - Text Equivalent


Footnote 1
Data from Quebec were not available for the rate ratio statistic but were estimated for the number of adults with hypertension.
Footnote 2
Data from Quebec were not available for the rate ratio statistics, but were included in the number of adults with diabetes who also had other health problems.

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