Report from the National Diabetes Surveillance System€¦ · Report from the National Diabetes Surveillance System: Diabetes in Canada, 2008 To promote and protect the health of

Report from the NationalDiabetes Surveillance System:

Diabetes in Canada, 2008

Report from the NationalDiabetes Surveillance System:

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To promote and protect the health of Canadians through leadership, partnership, innovation and action in public health.

— Public Health Agency of Canada

Report from the National Diabetes Surveillance System: Diabetes in Canada, 2008 is available on Internet at the following address: http://www.ndss.gc.ca

Aussi disponible en français sous le titre : Le Diabète au Canada : Rapport du système national de surveillance du dabète, 2008

To obtain additional copies, please contact:

Chronic Disease Surveillance Division Centre for Chronic Disease Prevention and Control 785 Carling Avenue, AL: 6806B Ottawa, Ontario K1A 0K9 Canada E-mail: [email protected]

This publication can be made available in alternative formats upon request.

© Her Majesty the Queen in Right of Canada, 2009

Cat. HP32-2/1-2008 ISBN: 978-0-662-05874-8

On line: Cat. HP32-2/1-2008E-PDF ISBN: 978-1-100-10280-1

4 5

Executive Summary

Diabetes• Diabetesisachronicconditionthatstemsfromthebody’sinabilitytoproduceand/orproperlyuseinsulin.Thebody

needs insulin to use sugar as an energy source. Diabetes can lead to serious complications and premature death. However, if someone has diabetes, steps can be taken to control the disease and lower the risk of complications.

National Diabetes Surveillance System (NDSS)• TheNationalDiabetesSurveillanceSystem(NDSS)isanetworkofprovincialandterritorialdiabetessurveillance

systems. It was created to improve the breadth of information about the burden of diabetes in Canada so that policymakers, researchers, health practitioners, and the general public could make better public and personal health decisions. The NDSS includes federal, and all provincial and territorial governments, non-governmental organizations, national Aboriginal groups, and researchers.

NDSS Highlights• In2005-2006,approximately1.9millionCanadians,oraboutonein17peoplehadbeendiagnosedwith

diabetes - 5.9% overall – 5.5% of girls and women and 6.2 % of boys and men.

• In2005-2006,theprevalence1 of diagnosed diabetes was lower among children and adolescents than adults. Theratesincreasedwithagefromabout2%inindividualsintheir30’stoabout22%,or1in5,inadultsaged 75 to 79 years old.

• Afteradjusting2 for differences in age distributions among provinces and territories, the prevalence1 of diagnosed diabetes was generally found to be highest in the Atlantic provinces (New Brunswick, Nova Scotia, Newfoundland and Labrador) and was lowest in the west (Saskatchewan, Alberta, and British Columbia). The prevalence1 for Ontario was higher than the national average, and for Quebec, prevalence was lower than the national average. Provincial and territorial obesity prevalence, followed a similar pattern; higher in the Atlantic provinces and lower in the western provinces.

• Theage-standardizedprevalence1 of diagnosed diabetes has increased by about 22% between 2001-2002 and 2005-2006.

• By2011,thenumberofCanadianswithdiagnoseddiabetesisexpectedtobeabout2.6million-anaverageannualpercent increase of almost 7% and an increase of about 33% from 2006.

• In2005-2006,199,471individualswerenewlydiagnosedwithdiabetes–arateof6.4per1,000population aged 1 and older, overall, and 5.9 per 1,000 among girls and women and 6.8 per 1,000 among boys and men.

• Thereisanincreasedriskofdevelopingdiabetesoverage40.Theentranceofthebabyboomgenerationintothe older age groups, and the rise in the prevalence1 of obesity, are associated with the rise in the diagnosed diabetes prevalence and incidence rates8. In addition, age-standardized prevalence1 is climbing at 3 times the rate of age-standardized incidence rates8, indicating that the increase in prevalence1 is due, also in part, to improved survival among individuals with diabetes.

• In2005-2006,amongadultsaged20yearsandolder,deathratesofindividualswithdiabetesweretwiceashighasthose in individuals without diabetes.

• Diagnoseddiabetesshortenslifeexpectancyforallages.Forexample,bothmenandwomeninthe25to39yearagegroupswithdiagnoseddiabeteshadabouta9yearreductioninlifeexpectancyin2005-2006.

• In2005-2006,youngeradults(aged20to49)withdiagnoseddiabeteshadabouttwiceasmanyvisitstofamily physicians and 2 to 3 times more visits to specialists than individuals without diabetes. Even in the oldest age groups, individuals with diagnosed diabetes visited physicians about 1.5 times more often than individuals without diabetes.

• In2005-2006,comparedtoadultswithoutdiabetes,adultswithdiagnoseddiabeteswerehospitalized:

• 23timesmoreoftenwithlowerlimbamputations;

• 7timesmoreoftenwithchronickidneydisease;

• 3timesmoreoftenwithoverallcardiovasculardiseaseincluding,hypertensivedisease,heartfailure,heartattack,ischaemic heart disease, and stroke.

6 7

Diabetes• Diabetesisachronicconditionthatstemsfromthebody’sinabilitytoproduceand/orproperlyuseinsulin.Thebody

needs insulin to use sugar as an energy source. Diabetes can lead to serious complications and premature death. However, controlling the disease can lower the risk of complications.

Type 1 Diabetes • Type1diabetesoccurswhenthebetacellsofthepancreasaredestroyedbytheimmunesystemandnolonger

produce insulin. An adequate supply of insulin is needed to help the body function. It usually develops in childhood or adolescence and there is no known way to prevent type 1 diabetes.

Type 2 Diabetes• Type2diabetesoccurswhenthebodydoesnotmakeenoughinsulinand/ordoesnotrespondwelltotheinsulinit

makes. People are usually diagnosed with type 2 diabetes after the age of 40, although it is now also being seen in children and adolescents.

Gestational Diabetes• Gestationaldiabetesisaformofdiabetesthatdevelopsinwomenduringpregnancyanddisappearsafterdelivery.

Gestational diabetes occurs in about 4% of all pregnancies and increases the risk of developing type 2 diabetes.

Reducing the Risk of Diabetes• Theriskofdevelopingdiabetescanbereducedbymakinghealthylifestylechoices,suchashavingahealthydiet,

losingexcessweightandexercisingregularly.Weightlossof5%to10%hasbeenshowntosignificantlyreduce risk—about 4.5 to 9 kg (10 to 20 lbs.) for a 90-kg (200-lb.) person.

Living with Diabetes • Treatmentdependsonthetypeofdiabetesandcanincludelifestylemodificationand/ormedications,includinginsulin.

Regular physical activity and healthy weight are important factors for effective management of diabetes. Controlling blood glucose, blood pressure and blood lipids are necessary to reduce the complications associated with diabetes. Self-management of diabetes is an essential part of overall care. Regular screening for complications and early treatment can also reduce complications.

National Diabetes Surveillance System (NDSS)• TheNationalDiabetesSurveillanceSystem(NDSS)isanetworkofprovincialandterritorialdiabetessurveillance

systems. It was created to improve the breadth of information about the burden of diabetes in Canada so that policymakers, researchers, health practitioners, and the general public could make better public and personal health decisions. The NDSS includes federal and all provincial and territorial governments, non-governmental organizations, national Aboriginal groups, and researchers.

• Ineachprovinceandterritory,thehealthinsuranceregistrydatabaseislinkedtothephysicianbillingandhospitalizationdatabases,inwhichhealthdataareprimarilystoredandreportedbyfiscalyear.Thisreportincludesthemostrecentdata available from the provinces and territories3,fiscalyear,2005-2006.

• Thelinkeddatabaseisusedtodesignateindividualswhohavediabetes4, based on the NDSS validated case criteria, whichusetheInternationalClassificationofDisease(ICD)standarddiabetescodes.

• Currently,theNDSScasecriteriadonotincludewomenwithgestationaldiabetes.Inaddition,thecriteriadonot distinguish between diabetes types in any of the reported rates due to limitations of the physician billing data and the hospital discharge abstract data in identifying type 1 and type 2 diabetes.

• InthelatestversionoftheICDsystem(ICD-10-CA)usedbyhospitalstorecordthedetailsofdiscretehospitalizations,separate codes for type 1 and type 2 diabetes are provided. It is anticipated that as additional ICD-10-CA coded hospital data are accumulated and validated, that it will be possible to analyze and report rates associated with hospitalizationstratifiedbydiabetestype.Forexample,therateofamputationsamongthosewithtype1diabetes versus those with type 2.

• Usingadministrativedataforsurveillance,asintheNDSS,oftenrequiresacompromisewhentryingtoidentifycasesof a disease. It is necessary to balance the possibility of misclassifying people who actually have been diagnosed with diabetes but who have not been captured by the NDSS as a diabetes case (false-negatives) with the reverse where people do not have diabetes but have been captured by the NDSS using the case criteria (false-positives). Validation studies have indicated that the NDSS case criteria minimize both false-negatives and false-positives in order to depict a relatively accurate picture of diagnosed diabetes in Canada. Additionally, there are some people who have not been diagnosed with diabetes, but in fact have the disease. Estimates for the number of people in this category are outside the scope of the NDSS.

PeopleWithDiagnosedDiabetes(Prevalence5)For People Aged 1 and Older:

• In2005-2006,approximately1.9millionCanadiansaged1andolder,orabout1in17,haddiagnoseddiabetes(1,939,247 overall, 925,523 among girls and women and 1,013,724 among boys and men). The prevalence among Canadians was 5.9% overall (5.5% of girls and women and 6.2% of boys and men). (Tables 1 and 2)

8 9

Sour

ce: P

ublic

Hea

lth A

genc

y of

Can

ada,

usin

g ND

SS d

ata

files

cont

ribut

ed b

y pr

ovin

ces

and

terri

torie

s, as

of A

ugus

t, 20

08

*Dat

a fo

r Nun

avut

wer

e un

avail

able.

%

5.

6 6.

4 6.

0 6.

0 6.

8 6.

4 6.

3 7.

2 6.

8 6.

7 7.

7 7.

2 7.

1 8.

1 7.

6

case

s 67

9,81

6 74

2,72

7 1,

422,

543

738,

431

807,

984

1,54

6,41

5 79

3,89

3 86

9,12

8 1,

663,

021

853,

346

933,

963

1,78

7,30

9 91

4,00

6 1,

001,

105

1,91

5,11

1

pop

12,1

73,7

68

11,6

27,5

76

23,8

01,3

44

12,3

61,9

57

11,8

13,9

39

24,1

75,8

96

12,5

48,0

93

11,9

99,9

80

24,5

48,0

73

12,7

38,2

42

12,1

86,9

41

24,9

25,1

83

12,9

38,3

39

12,3

85,1

39

25,3

23,4

78

6.0

1,42

2,54

3 23

,801

,344

5.6

679,

816

12,1

73,7

68

6.4

742,

727

11,6

27,5

76

6.4

1,54

6,41

5 24

,175

,896

6.0

738,

431

12,3

61,9

57

6.8

807,

984

11,8

13,9

39

6.8

1,66

3,02

1 24

,548

,073

6.3

793,

893

12,5

48,0

93

7.2

869,

128

11,9

99,9

80

7.2

1,78

7,30

9 24

,925

,183

6.7

853,

346

12,7

38,2

42

7.7

933,

963

12,1

86,9

41

7.6

1,91

5,11

125

,323

,478

7.1

914,

006

12,9

38,3

39

8.1

1,00

1,10

5 12

,385

,139

Tabl

e 1.

Pre

vale

nce

Perc

enta

ges,

Num

ber o

f Cas

es, a

nd In

cide

nce

Rate

s pe

r 1,0

00 o

f Dia

gnos

ed D

iabe

tes

by

Age

Grou

p, Y

ear,

and

Sex,

Can

ada*

, 200

1-20

02 to

200

5-20

06

W

omen

M

en

Tota

l*

Wom

en

Men

To

tal*

W

omen

M

en

Tota

l*

Wom

en

Men

To

tal*

W

omen

M

en

Tota

l*

2001

-200

2

20

02-2

003

2003

-200

4

20

04-2

005

2005

-200

6

D

iagn

osed

Dia

bete

s am

ong

Adul

ts A

ged

20 a

nd O

lder

D

iagn

osed

Dia

bete

s am

ong

Child

ren,

Age

d 1

Year

to 1

9

Prev

alen

ce (A

dults

with

Dia

gnos

ed D

iabe

tes)

Per

cent

ages

, Cas

es a

nd P

opul

atio

ns

1,

000

6.8

8.3

7.6

7.1

8.5

7.8

6.9

8.2

7.5

7.3

8.6

7.9

7.7

9.0

8.3

ca

ses

79,2

07

90,9

69

170,

176

83,2

73

93,9

78

177,

251

82,0

00

91,5

41

173,

541

87,6

55

97,1

96

184,

851

92,8

12

103,

401

196,

213

po

p 11

,573

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10

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22

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11

,706

,799

11

,099

,933

22

,806

,732

11

,836

,200

11

,222

,393

23

,058

,593

11

,972

,551

11

,350

,174

23

,322

,725

12

,117

,145

11

,487

,435

23

,604

,580

Inci

denc

e (A

dults

with

New

ly D

iagn

osed

Dia

bete

s) R

ates

per

1,0

00 P

eopl

e, C

ases

and

Pop

ulat

ions

%

0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3 0.

3

case

s 9,

722

10,5

43

20,2

65

10,2

28

11,2

26

21,4

54

10,7

65

11,7

66

22,5

31

11,1

92

12,1

92

23,3

84

11,5

17

12,6

19

24,1

36

pop

3,80

5,33

1 4,

003,

789

7,80

9,12

0 3,

795,

557

3,99

4,55

6 7,

790,

113

3,78

2,94

6 3,

979,

336

7,76

2,28

2 3,

770,

368

3,96

5,09

8 7,

735,

466

3,76

3,69

5 3,

957,

862

7,72

1,55

7

Gi

rls

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tal*

Gi

rls

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Gi

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Gi

rls

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rls

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20

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2002

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3

20

03-2

004

2004

-200

5

20

05-2

006

Prev

alen

ce (C

hild

ren

and

Adol

esce

nts

with

Dia

gnos

ed D

iabe

tes)

Per

cent

ages

, Cas

es a

nd P

opul

atio

n

1,

000

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

0.4

ca

ses

1,56

1 1,

596

3,15

7 1,

574

1,67

3 3,

247

1,62

1 1,

693

3,31

4 1,

542

1,64

7 3,

189

1,53

9 1,

719

3,25

8

pop

3,79

7,17

0 3,

994,

842

7,79

2,01

2 3,

786,

903

3,98

5,00

3 7,

771,

906

3,77

3,80

2 3,

969,

263

7,74

3,06

5 3,

760,

718

3,95

4,55

3 7,

715,

271

3,75

3,71

7 3,

946,

962

7,70

0,67

9

Inci

denc

e (C

hild

ren

and

Adol

esce

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with

New

ly D

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s) R

ates

per

1,0

00 P

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ases

and

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%

4.

3 4.

8 4.

6 4.

6 5.

2 4.

9 4.

9 5.

5 5.

2 5.

2 5.

9 5.

5 5.

5 6.

2 5.

9

case

s 68

9,53

8 75

3,27

0 1,

442,

808

748,

659

819,

210

1,56

7,86

9 80

4,65

8 88

0,89

4 1,

685,

552

864,

538

946,

155

1,81

0,69

3 92

5,52

3 1,

013,

724

1,93

9,24

7

pop

15,9

79,0

99

15,6

31,3

65

31,6

10,4

64

16,1

57,5

14

15,8

08,4

95

31,9

66,0

09

16,3

31,0

39

15,9

79,3

16

32,3

10,3

55

16,5

08,6

10

16,1

52,0

39

32,6

60,6

49

16,7

02,0

34

16,3

43,0

01

33,0

45,0

35

Fe

mal

es

Mal

es

Cana

da*

Fem

ales

M

ales

Ca

nada

* Fe

mal

es

Mal

es

Cana

da*

Fem

ales

M

ales

Ca

nada

* Fe

mal

es

Mal

es

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da*

20

01-2

002

2002

-200

3

20

03-2

004

2004

-200

5

20

05-2

006

D

iagn

osed

Dia

bete

s am

ong

Peop

le A

ged

1 Ye

ar a

nd O

lder

Prev

alen

ce (P

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e W

ith D

iagn

osed

Dia

bete

s) P

erce

ntag

es, C

ases

and

Pop

ulat

ions

for C

anad

a

1,

000

5.3

6.2

5.7

5.5

6.3

5.9

5.4

6.1

5.7

5.7

6.5

6.1

5.9

6.8

6.4

ca

ses

80,7

68

92,5

65

173,

333

84,8

47

95,6

51

180,

498

83,6

21

93,2

34

176,

855

89,1

97

98,8

43

188,

040

94,3

51

105,

120

199,

471

po

p 15

,370

,329

14

,970

,660

30

,340

,989

15

,493

,702

15

,084

,936

30

,578

,638

15

,610

,002

15

,191

,656

30

,801

,658

15

,733

,269

15

,304

,727

31

,037

,996

15

,870

,862

15

,434

,397

31

,305

,259

Inci

denc

e (P

eopl

e W

ith N

ewly

Dia

gnos

ed D

iabe

tes)

Rat

es p

er 1

,000

Peo

ple,

Cas

es a

nd P

opul

atio

ns fo

r Can

ada

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 *Data for Nunavut were unavailable.

1-19 Rates 0.3% 0.3% 0.3% 0.4 per 1,000 0.4 per 1,000 0.4 per 1,000

Cases 11,517 12,619 24,136 1,539 1,719 3,258 Population 3,763,695 3,957,862 7,721,557 3,753,717 3,946,962 7,700,679

20-24 Rates 0.7% 0.6% 0.7% 0.9 per 1,000 0.6 per 1,000 0.7 per 1,000

Cases 7,598 7,002 14,600 947 702 1,649 Population 1,109,116 1,141,060 2,250,176 1,102,465 1,134,760 2,237,225

25-29 Rates 1.1% 0.8% 0.9% 1.5 per 1,000 1.1 per 1,000 1.3 per 1,000


30-34 Rates 1.7% 1.4% 1.5% 2.5 per 1,000 2.1 per 1,000 2.3 per 1,000


35-39 Rates 2.4% 2.3% 2.3% 3.3 per 1,000 3.7 per 1,000 3.5 per 1,000


40-44 Rates 3.2% 3.5% 3.4% 4.5 per 1,000 5.6 per 1,000 5.0 per 1,000


45-49 Rates 4.5% 5.5% 5.0% 6.1 per 1,000 8.0 per 1,000 7.0 per 1,000


50-54 Rates 6.7% 8.7% 7.7% 8.9 per 1,000 12.1 per 1,000 10.5 per 1,000


55-59 Rates 9.8% 13.1% 11.4% 12.1 per 1,000 16.4 per 1,000 14.2 per 1,000

Cases 102,897 136,277 239,174 11,713 15,099 26,812 Population 1,055,657 1,043,827 2,099,484 964,473 922,649 1,887,122

60-64 Rates 12.8% 17.4% 15.0% 14.9 per 1,000 20.3 per 1,000 17.5 per 1,000

Cases 101,272 134,699 235,971 10,509 13,238 23,747 Population 794,194 775,120 1,569,314 703,431 653,659 1,357,090

65-69 Rates 16.1% 21.3% 18.6% 17.9 per 1,000 23.7 per 1,000 20.6 per 1,000

Cases 102,877 127,548 230,425 9,751 11,438 21,189 Population 638,283 597,836 1,236,119 545,157 481,726 1,026,883

70-74 Rates 18.7% 23.7% 21.0% 18.9 per 1,000 24.1 per 1,000 21.3 per 1,000

Cases 106,303 119,143 225,446 8,874 9,509 18,383 Population 567,927 503,867 1,071,794 470,498 394,233 864,731

75-79 Rates 20.2% 24.8% 22.0% 18.9 per 1,000 23.1 per 1,000 22.2 per 1,000

Cases 100,892 97,325 198,217 7,677 6,990 14,667 Population 499,898 392,536 892,434 406,683 302,201 708,884

80-84 Rates 20.0% 23.9% 21.5% 17.5 per 1,000 21.3 per 1,000 18.9 per 1,000


85+ Rates 16.8% 19.8% 17.8% 14.9 per 1,000 17.5 per 1,000 15.7 per 1,000


Canada Rates 5.5% 6.2% 5.9% 5.9 per 1,000 6.8 per 1,000 6.4 per 1,000

Cases 925,523 1,013,724 1,939,247 94,351 105,120 199,471 Population 16,702,034 16,343,001 33,045,035 15,870,862 15,434,397 31,305,259

0.3% 24,136

7,721,557

0.7% 14,600

2,250,176

0.9% 20,986

2,222,989

1.5% 34,969

2,294,981

2.3% 57,784

2,470,846

3.4% 96,325

2,863,418

5.0% 137,978

2,745,599

7.7% 184,962

2,401,071

11.4% 239,174

2,099,484

15.0% 235,971

1,569,314

18.6% 230,425

1,236,119

21.0% 225,446

1,071,794

22.0% 198,217 892,434

21.5% 140,336 653,497

17.8% 97,938

551,756

5.9% 1,939,247

33,045,035

0.3% 11,517

3,763,695

0.7% 7,598

1,109,116

1.1% 11,852

1,112,207

1.7% 19,309

1,148,564

2.4% 29,332

1,232,181

3.2% 45,648

1,424,866

4.5% 61,948

1,371,505

6.7% 80,817

1,206,207

9.8% 102,897

1,055,657

12.8% 101,272 794,194

16.1% 102,877 638,283

18.7% 106,303 567,927

20.2% 100,892 499,898

20.0% 79,695

399,484

16.8% 63,566

378,250

5.5% 925,523

16,702,034

0.3% 12,619

3,957,862

0.6% 7,002

1,141,060

0.8% 9,134

1,110,782

1.4% 15,660

1,146,417

2.3% 28,452

1,238,665

3.5% 50,677

1,438,552

5.5% 76,030

1,374,094

8.7% 104,145

1,194,864

13.1% 136,277

1,043,827

17.4% 134,699 775,120

21.3% 127,548 597,836

23.7% 119,143 503,867

24.8% 97,325

392,536

23.9% 60,641

254,013

19.8% 34,372

173,506

6.2% 1,013,724

16,343,001

0.4 per 1,0003,258

7,700,679

0.7 per 1,0001,649

2,237,225

1.3 per 1,0002,907

2,204,910

2.3 per 1,0005,290

2,265,302

3.5 per 1,0008,496

2,421,558

5.0 per 1,00013,943

2,781,036

7.0 per 1,00018,500

2,626,121

10.5 per 1,00023,492

2,239,601

14.2 per 1,00026,812

1,887,122

17.5 per 1,00023,747

1,357,090

20.6 per 1,00021,189

1,026,883

21.3 per 1,00018,383

864,731

22.2 per 1,00014,667

708,884

18.9 per 1,0009,882

523,043

15.7 per 1,0007,256

461,074

6.4 per 1,000199,471

31,305,259

0.4 per 1,000 1,539

3,753,717

0.9 per 1,000 947

1,102,465

1.5 per 1,000 1,705

1,102,060

2.5 per 1,000 2,854

1,132,109

3.3 per 1,000 4,021

1,206,870

4.5 per 1,000 6,178

1,385,396

6.1 per 1,000 7,972

1,317,529

8.9 per 1,000 10,160

1,135,550

12.1 per 1,000 11,713

964,473

14.9 per 1,000 10,509

703,431

17.9 per 1,000 9,751

545,157

18.9 per 1,000 8,874

470,498

18.9 per 1,000 7,677

406,683

17.5 per 1,000 5,680

325,469

14.9 per 1,000 4,771

319,455

5.9 per 1,000 94,351

15,870,862

0.4 per 1,000 1,719

3,946,962

0.6 per 1,000 702

1,134,760

1.1 per 1,000 1,202

1,102,850

2.1 per 1,000 2,436

1,133,193

3.7 per 1,000 4,475

1,214,688

5.6 per 1,000 7,765

1,395,640

8.0 per 1,000 10,528

1,308,592

12.1 per 1,000 13,332

1,104,051

16.4 per 1,000 15,099

922,649

20.3 per 1,000 13,238

653,659

23.7 per 1,000 11,438

481,726

24.1 per 1,000 9,509

394,233

23.1 per 1,000 6,990

302,201

21.3 per 1,000 4,202

197,574

17.5 per 1,000 2,485

141,619

6.8 per 1,000 105,120

15,434,397

Table 2. Prevalence Percentages, Incidence Rates, and Number of Cases of Diagnosed Diabetes, by Sex and Age Group, Canada*, 2005-2006

Females Males Canada* Females Males Canada*

Prevalence Incidence

Age Group

10 11

• Asanticipated,in2005-2006,asinprioryears,theprevalence5ofdiagnoseddiabeteswassignificantlyloweramongchildren and adolescents than adults. The prevalence increased with age from about 2% among individuals in their 30’stoabout22%,or1in5,adultsaged75to79yearsold.(Figure 1 and Table 2)

• Afteradjusting6 for differences in age distributions among provinces and territories, the prevalence5 of diagnosed diabetes was generally found to be highest in the Atlantic provinces (New Brunswick, Nova Scotia, Newfoundland and Labrador) and was lowest in the west (Saskatchewan, Alberta, and British Columbia). The prevalence for Ontario was higher than the national average, and for Quebec, prevalence was lower than the national average. (Figure 2) Provincial and territorial obesity prevalence, followed a similar pattern; higher in the Atlantic provinces and lower in the western provinces.

• Afteradjusting6 to account for changes in the age distributions over time, the prevalence5 of diagnosed diabetes has increased by about 22% between 2001-2002 and 2005-2006. (Figure 3)

0

5

10

15

20

25

Females Males

FemalesMales

Both

Figure 1. Prevalence Percentages of Diagnosed Diabetes among People Aged 1 Year and Older by Age Group and Sex, Canada*, 2005-2006

Age Group

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 *Data for Nunavut were unavailable. ‡The 95% Confidence Interval shows an estimated range of values which is likely to include the true prevalence rate 19 times out of 20.

0.3 0.7 1.1 1.7 2.4 3.2 4.5 6.7 9.7 12.8 16.1 18.7 20.2 19.9 16.8 0.3 0.6 0.8 1.4 2.3 3.5 5.5 8.7 13.1 17.4 21.3 23.6 24.8 23.9 19.8 0.3 0.6 0.9 1.5 2.3 3.4 5.0 7.7 11.4 15.0 18.6 21.0 22.2 21.5 17.8

1-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

(Per

cent

age)

Canada*

5.56.25.9

FemalesMales

Both

0

1

2

3

4

5

6

YT NT BC AB SK MB ON QC NB NS PE NL Canada*

5.5 5.0 4.2 4.0 4.4 5.0 4.9 4.0 5.3 5.2 4.4 5.3 4.54.6 4.8 5.2 5.1 5.3 5.8 5.9 5.2 6.1 6.2 5.8 5.7 5.55.0 4.9 4.6 4.5 4.8 5.4 5.3 4.5 5.7 5.7 5.1 5.5 5.0

Females Males

Figure 2. Age-Standardized Prevalence Percentages* of Diagnosed Diabetes among People Aged 1 Year and Older, by Sex, Province and Territory, Canada^, 2005-2006

(Per

cent

age)

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 *Age-standardized to 1991 Canadian population^Data for Nunavut were unavailable. ‡The 95% Confidence Interval shows an estimated range of values which is likely to include the true prevalence rate 19 times out of 20.YT: Yukon, NT: Northwest Territories, BC: British Columbia, AB: Alberta, SK: Saskatchewan, MB: Manitoba, ON: Ontario, QC: Quebec, NB: New Brunswick,NS: Nova Scotia, PE: Prince Edward Island, NL: Newfoundland

Females Males

FemalesMales

Both

Figure 3. Age-Standardized Prevalence Percentages* of Diagnosed Diabetes among People Aged 1 Year and Older, by Sex, Canada^, 2001-2002 to 2005-2006

Fiscal Year

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 *Age-standardized to 1991 Canadian population^Data for Nunavut were unavailable. ‡The 95% Confidence Interval shows an estimated range of values which is likely to include the true prevalence rate 19 times out of 20.

2001-2002 2002-2003 2003-2004 2004-2005 2005-2006

3.7 3.9 4.1 4.3 4.5 4.6 4.8 5.1 5.3 5.5 4.1 4.3 4.5 4.8 5.0

4

5

(Per

cent

age)

12 13

Forecasted Prevalence5,7 For People Aged 1 and Older:

• By2011,thenumberofCanadianswithdiagnoseddiabetesisexpectedtobeabout2.6million-anaverageannualpercent increase of almost 7% and an increase by about 33% since 2006. (Figure 4)

• By2010-2011,oneinthree(35%)ofpeoplewithdiabeteswillbeinthe50to64yearoldagerange,duetothe increased risk of developing diabetes over age 40, the entrance of the baby boom generation into the older age groups, and the rise in the prevalence5 of obesity. (Figures 5 and 6)

Females Males

FemalesMales

Both

Figure 4. Observed and Projected Prevalent Number of Cases* of Diagnosed Diabetes among People Aged 1 Year and Older, by Sex, Canada^, Observed: 2001-2002 to 2005-2006 and Projected: 2006-2007 to 2010-2011

Fiscal Year

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 *Counts were rounded to the nearest 100.^Data for Nunavut were unavailable for the observed prevalent counts.

2001-2002 2002-2003 2003-2004 2004-2005 2005-2006 2006-2007 2007-2008 2008-2009 2009-2010 2010-2011600,000

900,000

1,200,000

1,500,000

689,538 748,659 804,658 864,538 925,523 988,800 1,049,400 1,109,200 1,168,300 1,226,800 753,270 819,210 880,894 946,155 1,013,724 1,083,400 1,150,100 1,215,900 1,280,800 1,345,000 1,442,808 1,567,869 1,685,552 1,810,693 1,939,247 2,072,200 2,199,500 2,325,100 2,449,100 2,571,800

(Pre

vale

nt C

ount

)

0

30,000

60,000

90,000

120,000

150,000

Figure 5. Observed and Projected Prevalent Number of Cases* of Diagnosed Diabetes among Girls and Women Aged 1 Year and Older, by Age Group, Canada^, Observed: 2001-2002, 2005-2006 Projected: 2006-2007 and 2010-2011

2001-2002 2005-2006

2001-2002

2005-2006

2006-2007

2010-2011

1-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

9,722 6,157 9,445 14,603 23,436 33,374 45,162 61,158 67,429 71,950 81,035 86,832 80,373 54,708 44,15411,517 7,598 11,852 19,309 29,332 45,648 61,948 80,817 102,897 101,272 102,877 106,303 100,892 79,695 63,56612,000 8,100 12,700 20,300 31,100 48,100 66,900 86,900 110,500 110,000 109,400 110,300 105,900 84,700 71,90013,300 9,600 15,400 23,900 36,600 55,100 82,900 110,600 140,100 146,400 140,200 129,700 122,500 100,700 99,900

Age Group

(Pre

vale

nt C

ount

)

2006-2007 2010-2011


Figure 6. Observed and Projected Prevalent Number of Cases* of Diagnosed Diabetes among Boys and Men Aged 1 Year and Older, by Age Group, Canada^, Observed: 2001-2002, 2005-2006 Projected: 2006-2007 and 2010-2011

0

50,000

100,000

150,000

200,0002001-2002 2005-2006

2006-2007 2010-2011

2001-2002

2005-2006

2006-2007

2010-2011

1-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

10,543 5,432 7,623 13,175 23,826 38,160 57,210 82,956 93,046 94,888 98,291 93,578 71,196 40,265 23,08112,619 7,002 9,134 15,660 28,452 50,677 76,030 104,145 136,277 134,699 127,548 119,143 97,325 60,641 34,37213,100 7,400 9,900 16,500 29,900 53,400 81,800 111,200 145,000 145,200 135,600 124,900 104,300 65,900 39,50014,600 8,700 12,300 19,700 34,600 60,300 100,000 138,600 178,500 188,400 172,300 148,800 126,400 84,000 57,700

Age Group


(Pre

vale

nt C

ount

)

14 15

PeopleWithNewlyDiagnosedDiabetes(Incidence8) For People Aged 1 Year and Older:

• In2005-2006,199,471individualswerenewlydiagnosedwithdiabetes–arate8 of 6.4 per 1,000 population aged 1 and older, overall, and 5.9 per 1,000 among girls and women and 6.8 per 1,000 among boys and men. (Tables 1, 2, and Figure 7)

• In2005-2006,incidencerates8 of diagnosed diabetes were lower for children and adolescents than for adults. The rates rosesteeplyafterage45andpeakedamongbothmenandwomeninthe70-74agegroup.Theratesweresignificantlyhigher among men than women over age 40. (Table 2 and Figure 7)

• Afteradjusting6 to account for changes in the age distributions across time, the incidence rates8 of diagnosed diabetes have increased by about 7% between 2001-2002 and 2005-2006. (Figure 8) Rising age-standardized incidence rates8 are likely a reflection of the rising prevalence5 of obesity. In addition, age-standardized prevalence is climbing at 3 times the rate of age-standardized incidence rates, indicating that the increase in prevalence is also due, in part, to improved survival among individuals with diabetes.

0

5

10

15

20

25

Females Males

FemalesMales

Both

Figure 7. Incidence Rates of Diagnosed Diabetes among People Aged 1 Year and Older, by Age Group and Sex, Canada*, 2005-2006

Age Group

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 *Data for Nunavut were unavailable. ‡The 95% Confidence Interval shows an estimated range of values which is likely to include the true incidence rate 19 times out of 20.

0.4 0.9 1.5 2.5 3.3 4.5 6.1 8.9 12.1 14.9 17.9 18.9 18.9 17.5 14.9 0.4 0.6 1.1 2.1 3.7 5.6 8.0 12.1 16.4 20.3 23.7 24.1 23.1 21.3 17.5 0.4 0.7 1.3 2.3 3.5 5.0 7.0 10.5 14.2 17.5 20.6 21.3 20.7 18.9 15.7

1-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Canada*

5.96.86.4

(Rat

e pe

r 1,0

00)

Females Males

FemalesMales

Both

Figure 8. Age-Standardized Incidence Rates* of Diagnosed Diabetes among People Aged 1 Year and Older, by Sex, Canada^, 2001-2002 to 2005-2006

Fiscal Year

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 *Age-standardized to 1991 Canadian population^Data for Nunavut were unavailable. ‡The 95% Confidence Interval shows an estimated range of values which is likely to include the true incidence rate 19 times out of 20.

2001-2002 2002-2003 2003-2004 2004-2005 2005-2006

4.8 4.9 4.8 5.0 5.2 6.2 6.3 6.0 6.2 6.5 5.4 5.6 5.4 5.6 5.8

4

5

6

7

(Rat

e pe

r 1,0

00)

16 17

DeathsAmongPeopleWithDiagnosedDiabetes(Mortality9)For Adults Aged 20 Years and Older:

• In2005-2006,amongadultsaged20yearsandolder,overalldeathratesweretwiceashighinindividualswithdiabetescompared to individuals without diabetes.

• Thedifferencesinmortalityratesforpeoplewithandwithoutdiabetesarehigheramongtheyoungeragegroups.Younger adults, those aged 20 to 44, with diabetes die at rates that are 4 to 6 times higher than those without diabetes. Whileforadultsaged45to79,theratesare2to3timeshigherinindividualswithdiabetes. (Figure 9)

YearsofLifeRemainingforPeopleWithDiagnosedDiabetes• Diabetesshortenslifeexpectancyforallages.Forexample,in2005-2006,bothmenandwomenwith

diagnoseddiabetes,inthe25to39yearagegroups,hadaboutan8-yearreductioninlifeexpectancy in 2005-2006. (Figure 10)

• Bothgirlsandboyswithdiagnoseddiabetesinthe1to19yearagegrouphadabouta10-to11-year reductioninlifeexpectancyin2005-2006.(Figure 10)

Women Men

WomenMenBoth

Figure 9. All-Cause Death Rate Ratios among Women and Men Aged 20 Years and Older with Diagnosed Diabetes Compared to Those without Diagnosed Diabetes, Canada^, 2005-2006

Age Group

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 *Data for Nunavut were unavailable. ‡The 95% Confidence Interval shows an estimated range of values which is likely to include the true death rate 19 times out of 20.

9.9 6.2 4.5 5.2 4.2 3.1 3.3 2.7 2.4 2.4 2.1 1.9 1.7 1.33.8 4.5 5.4 4.4 3.4 2.7 2.7 2.3 2.2 1.9 1.7 1.6 1.5 1.35.5 4.8 4.9 4.7 3.7 2.9 3.0 2.6 2.4 2.1 1.9 1.7 1.6 1.3

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+0

5

10

15

20

(All-

Caus

e De

ath

Rate

Rat

ios)

0

20

40

60

80

100Females without Diabetes

Females without Diabetes

Females with Diabetes

Males without Diabetes

Males with Diabetes

Figure 10. Years of Life Remaining for People with Diagnosed Diabetes Compared to Those without Diagnosed Diabetes, by Age Group and Sex, Canada*, 2003-2004 to 2005-2006

Age Group

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, August, 2008 *Data for Nunavut were unavailable.

1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+84 80 75 70 65 61 56 51 46 41 36 32 27 23 19 15 12 973 69 64 60 55 51 47 42 38 34 29 25 21 18 14 11 9 779 75 70 65 60 56 51 46 41 37 32 27 23 19 15 12 9 769 65 60 56 51 47 43 39 34 30 26 22 19 15 12 9 7 5

Females with Diabetes

Males without Diabetes

Males with Diabetes

(Yea

rs o

f Life

Rem

aini

ng)

18 19

HealthServicesUtilizationTwo measures of health services utilization are the number of visits to physicians (family physicians and specialists) and the length (days) of hospital stays.

For Adults Aged 20 Years and Older:

• In2005-2006,youngeradults(aged20to49)withdiagnoseddiabeteshadabout2timesasmanyvisitstofamilyphysicians (Figure 11) and 2 to 3 times as many visits to specialists (Figure 12) than individuals without diabetes. Even in the oldest age groups, individuals with diagnosed diabetes visited physicians about 1.5 times more than individuals without diabetes.

• Duringthe2005-2006fiscalyear,adultswithdiagnoseddiabetesstayedmoredaysinhospitalthanindividualswithoutdiabetes. For hospitalized adults with diagnosed diabetes, aged 20 to 29 and 35 to 54 years old, the number of days stayed in hospital was about 4 to 6 times the number of days stayed by individuals without diabetes. Among those older than 54 years, the ratio of days stay between those with diabetes and those without ranged from 2 to 3. (Figure 13)

For Children and Adolescents Aged 1 to 19 Years Old:

• Childrenandadolescentswithdiagnoseddiabeteshadabout1.5timesmorevisitstofamilyphysicians(Figure 11) and 4 times as many visits to specialists (Figure 12) as children and adolescents without diabetes, in 2005-2006.

• During2005-2006,hospitalizedchildrenandadolescentswithdiagnoseddiabetes,aged1to19,stayedabout 8 to 11 times the number of days in hospital than hospitalized individuals without diabetes. (Figure 13)

Females Males

FemalesMales

Both

Figure 11. Ratio of the Rates of Visits to Family Physicians among People Aged 1 Year and Older with Diagnosed Diabetes Compared to Those without Diagnosed Diabetes, by Age Group and Sex, Canada^, 2005-2006

Age Group

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of August, 2008 ^Quebec data were excluded from analysis and data from Nunavut were unavailable. ‡The 95% Confidence Interval shows an estimated range of values which is likely to include the true rate ratio 19 times out of 20.

1.6 1.7 1.7 1.8 2.0 2.0 1.9 1.8 1.7 1.7 1.5 1.5 1.4 1.3 1.3 1.4 2.1 2.3 2.4 2.3 2.3 2.2 2.0 1.9 1.7 1.6 1.5 1.4 1.3 1.3 1.5 1.9 2.0 2.0 2.1 2.1 2.0 1.9 1.8 1.7 1.6 1.5 1.4 1.3 1.3

1-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

1.5

2.0

2.5

(R

atio

of t

he R

ates

of V

isits

)

Females Males

FemalesMales

Both

Figure 12. Ratio of the Rates of Visits to Specialists among People Aged 1 Year and Older with Diagnosed Diabetes Compared to Those without Diagnosed Diabetes, by Age Group and Sex, Canada^, 2005-2006

Age Group


4.6 3.1 2.3 2.1 2.2 2.2 2.0 1.9 1.8 1.7 1.6 1.5 1.4 1.3 1.3 3.6 3.4 3.7 3.4 3.0 2.8 2.5 2.3 2.1 1.9 1.7 1.6 1.5 1.4 1.4 4.0 3.2 2.8 2.5 2.5 2.4 2.2 2.0 1.9 1.8 1.7 1.6 1.5 1.4 1.4

1-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+1

2

3

4

(R

atio

of t

he R

ates

of V

isits

)

Females Males

FemalesMales

Both

Figure 13. Ratio of the Rates of Days Stayed in Hospital among People Aged 1 Year and Older with Diagnosed Diabetes Compared to Those without Diagnosed Diabetes, by Age Group and Sex, Canada^, 2005-2006

Age Group


11.3 6.1 3.5 3.1 4.1 4.0 3.9 4.2 3.6 3.2 2.8 2.4 2.1 1.8 1.5 8.0 5.2 6.5 8.3 5.5 4.6 3.8 3.6 3.2 2.7 2.3 2.1 1.8 1.7 1.5 9.6 5.8 4.4 4.5 4.6 4.3 3.9 3.8 3.4 2.9 2.5 2.3 2.0 1.7 1.5

1-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+

10

8

6

4

2

0

(Rat

io o

f the

Rat

es o

f Day

s St

ay)

20 21

Other Health Problems10 Eight heath problems, for which hospitalizations are common among individuals with diagnosed diabetes, are currently tracked by the NDSS. They are chronic kidney disease, lower limb amputations, and cardiovascular disease – which include but are not limited to: hypertensive disease, heart failure, heart attack, ischaemic heart disease, and stroke.

For Adults Aged 20 Years and Older:

• In2005-2006,themostcommonhealthproblemseeninhospitalizationsamongindividualswithdiagnoseddiabeteswas for cardiovascular disease (about 9%). (Table 3)

• During2005-2006,adults,aged20yearsandolder,withdiagnoseddiabeteswerehospitalizedmoreoftenthantheircounterparts without diagnosed diabetes11 (Table 3):

• 23timesmoreoftenwithlowerlimbamputations;

• 7timesmoreoftenwithchronickidneydisease;

• 3timesmoreoftenwithallcardiovasculardiseases;

• 4timesmoreoftenwithhypertensivediseaseandheartfailureand,

• 3timesmoreoftenwithheartattack,ischaemicheartdisease,andstroke.

NDSS Future PlansThe NDSS provides a valuable source of information about diabetes in Canada. Future work will include:

• ContinuingworkwithFirstNations,Métis,andInuitorganizationstoproduceNDSSdataforanalysis,interpretation, and up-to-date reporting, to gain a better understanding of diabetes among these populations;

• Expandingthebreadthofdatareportingondiabetesandotherrelatedconditionsamongadults,children, and adolescents;

• ExploringtheuseofICD-10-CAdiagnosiscodinginhospitalsandpharmaceuticaldatatodifferentiatebetween types of diabetes; and,

• Developingacollaborativestandardapproachtoimprovinganddocumentingdataquality.

Source: Public Health Agency of Canada, using NDSS data files contributed by provinces and territories, as of September, 2008 *Select comorbid conditions were for the following: cardiovascular disease, hypertensive disease, ischaemic heart disease, acute myocardial infarction, heart failure, cerebrovascular disease, chronic kidney disease, and lower limb amputations. An individual may have more than one comorbid hospitalization, and is only counted once in each category. **Data are rate ratios of age-standardized rates. Rates are age-standardized to the 1991 Canadian population. ^Quebec data were excluded from analysis and data from Nunavut were unavailable. ***When more than one hospitalization is recorded in one of the highlighted cardiovascular disease categories: hypertensive disease, ischaemic heart disease, acute myocardial infarction, heart failure, or cerebrovascular disease, an individual with diagnosed diabetes is counted only once under this broader cardiovascular disease category. ****Lower limb amputations exlcude those caused by trauma or cancer.

Table 3. Numbers and Percentages of Individuals with Diagnosed Diabetes Hospitalized with Select Comorbid Hospitalizations* and Rate Ratios** for Individuals with Diagnosed Diabetes Compared to Those without Diagnosed Diabetes, Women and Men Aged 20 Years and Older, Canada^, 2005-2006

Individuals with Diagnosed Diabetes Compared to Those without Diagnosed Diabetes

Individuals with Diagnosed Diabetes Hospitalized for Select Comorbid Hospitalizations*

Individuals Percentages Rate Ratios**Select Comorbid Hospitalizations*

Cardiovascular Disease*** 131,102 8.8% 3.1 Hypertensive Disease 72,845 4.9% 3.9 Ischaemic Heart Disease 57,726 3.9% 3.3 Heart Attack (Acute Myocardial Infarction) 19,847 1.3% 3.2 Heart Failure 35,343 2.4% 3.7 Stroke (Cerebrovascular Disease) 16,553 1.1% 2.7Chronic Kidney Disease 26,120 1.7% 7.1Lower Limb Amputations**** 2,657 0.2% 23.0

Individuals with Diagnosed Diabetes 1,495,676

22 23

AcknowledgementsTheNDSSisguidedbythePublicHealthNetwork’sTaskGrouponSurveillanceofChronicDiseaseandInjurywiththefol-lowing members:

AlbertaHealthandWellnessBritish Columbia Ministry of Healthy Living and SportCanadian Institute of Health InformationCanadian Institutes of Health Research-Institute of Nutrition, Metabolism and DiabetesGovernment of NunavutGovernment of YukonHealth Canada, First Nations and Inuit Health BranchInstitutnationaldesantépubliqueduQuébecManitoba HealthNewBrunswickDepartmentofHealthandWellnessNewfoundland and Labrador Centre for Health InformationNorthwest Territories Department of Health and Social ServicesNova Scotia Department of Health, Diabetes Care Program of Nova ScotiaOntario Ministry of Health and Long-Term Care and Ministry of Health PromotionPrince Edward Island Department of HealthPublic Health Agency of CanadaSaskatchewan HealthStatistics Canada

ExpertadvicewasprovidedbythemembersoftheNDSSScientificWorkingGroup:

GillianBooth,St.Michael’sHospital,UniversityofTorontoKayla Collins, Newfoundland and Labrador Centre for Health InformationHasan Hutchinson/Paul Belanger, Institute of Nutrition Metabolism and Diabetes, Canadian Institutes of Health ResearchJeffreyJohnson,SchoolofPublicHealth,UniversityofAlbertaIsabelleLarocque,InstitutnationaldesantépubliqueduQuébecMarty Pearce/Kara McDonald, Consultants to British Ministry of Healthy Living and SportRolf Puchtinger, Chronic Disease Branch, Manitoba Health and Healthy LivingIndra Pulcins, Canadian Institute for Health InformationKim Reimer, Prevention and Health Promotion, British Columbia Ministry of Healthy Living and SportMarkSmith,DalhousieUniversity,Halifax,NovaScotiaBaiju Shah/Shazhan Ahmed, Institute for Evaluative and Clinical Sciences, OntarioLarrySvenson,PublicHealthSurveillanceandEnvironmentalHealth,AlbertaHealthandWellnessEllenToth,DepartmentofMedicine,UniversityofAlbertaLinda Van Til, Research Directorate, Veteran Affairs Canada

DataqualityandverificationexpertiseareprovidedbythemembersoftheNDSSTechnicalWorkingGroup:

FredAckah.AlbertaHealthandWellnessConnie Cheverie, Prince Edward Island Department of HealthWendyFonseca-Holt,ChronicDiseaseBranch,ManitobaHealthandHealthyLivingJanice Hawkey, Saskatchewan HealthAlexanderKopp,InstituteofClinicalandEvaluativeServicesPat McCrea, British Columbia Ministry of Healthy Living and SportRobin Read, Diabetes Care Program of Nova ScotiaLouisRochette,InstitutnationaldesantépubliqueduQuébecAnthony Leamon, Population Health, Department of Health and Social Services, Government of the Northwest TerritoriesKhokan Sikdar, Newfoundland and Labrador Centre for Health InformationMike Tribes, Government of Yukon, Health and Social ServicesRowenaTervo,DepartmentofHealthandWellness,NewBrunswickPaulTchouaffi,DepartmentofHealthandSocialServices,HealthInformationandResearch,Iqualuit,Nunavut

A newly formed Diabetes Surveillance Advisory Committee, chaired by the Canadian Diabetes Association, advises PHAC on diabetes surveillance in Canada.

24 25

Footnotes1 The proportion of individuals that are affected by diagnosed diabetes at a given point in time.

2 Foramoredetailedexplanationoftheage-standardizationtechnique,refertothemethodsforthisreportontheNDSSwebsite: www.ndss.gc.ca.

3 Nunavut was unable to provide the 2008 data submission for this report.

4 Fromthispointforward,diabetesreferstotheNDSScasedefinitionfordiagnoseddiabetes.

5 The proportion of individuals that are affected by diagnosed diabetes at a given point in time.

6 Foramoredetailedexplanationoftheage-standardizationtechnique,refertothemethodsforthisreportontheNDSSwebsite: www.ndss.gc.ca.

7 These statistics were calculated using estimates for future populations from Statistics Canada and the assumption that both future NDSS incidence and mortality rates remain constant.

8 The rate of individuals newly diagnosed with diabetes during the year.

9 Data are ratios of age-standardized rates.

10 These select health problems are diagnosed in hospital. Refer to the NDSS methods for more information on the NDSS website: www.ndss.gc.ca. Data are ratios of age-standardized rates.

11Dataareratiosofage-specificrates.

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