Twenty Years of Diabetes surveillance using the Canadian Chronic Disease Surveillance System

What is diabetes?

Diabetes occurs when the body is unable to produce and/or use insulin. Insulin is a hormone that regulates blood sugar (blood glucose) and is essential for normal bodily function^{Footnote 1}. There are three main types of diabetes:

Type 1: Body does not produce insulin.
Type 2: Body can produce insulin but either not enough, or is not able to use it properly.
Gestational diabetes: A temporary condition during pregnancy when the body can produce insulin but is not able to use it properly.

According to national data:

Almost 3.2 million Canadians are living with diabetes^{Footnote 2}.
- That is:
  - 1 in 333 children (ages 1 to 19 years)
  - 1 in 9 adults (aged 20 years and older)
An average of 549 Canadians are diagnosed with diabetes every day^{Footnote 2}
- that is approximately 201,000 new cases per year
Among Canadian adults (aged 20 years and older)
- 6.1% have pre-diabetes^{Footnote 3}
- 7.0% have high blood glucose^{Footnote 3} and 1.7% live with undiagnosed high blood glucose
- 90.3% have blood glucose in the normal range
1 in 10 women who give birth have diabetes while pregnant^{Footnote 4}
The all-cause mortality rate among Canadians with diabetes is twice as high as the all-cause mortality rate for those without diabetes^{Footnote 2}

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Organization: Public Health Agency of Canada
Date published:11-12-2019

Type 2 diabetes

Risk factor

Obesity
Physical inactivity
Unhealthy diet
Ethnicity^{Footnote *}
Increased age
Sex
Lower socio-economic status

Complications

Reduced life expectancy
Cardiovascular disease
Vision loss
Kidney failure
Nerve damage
Amputations

Who is at risk?

Diabetes is more common among adult men (11.8%) than women (10.0%), but in children and youth, the rates are the same for boys and girls.
Less than 1% of diabetes cases in Canada are among those aged 1-19 years old, while over half of all diabetes cases in Canada are among those aged 65 years and older. Type 1 diabetes is most often diagnosed in children whereas type 2 diabetes is most often diagnosed among adults. Women who develop gestational diabetes are at greater risk for developing type 2 diabetes later in life.
Type 1 diabetes is an autoimmune disease and is not preventable. The causes of type 1 diabetes are not fully understood but include both genetic and environmental factors.
Type 2 diabetes is caused by a wide range of individual, social, environmental, and genetic factors^{Footnote 1} ^{Footnote 5}.
Some of these factors, such as obesity and physical inactivity, may be modifiable at the individual level; others, such as ethnicity, are non-modifiable. Some factors like food insecurity, social support, and built environment related to the social determinants of health can influence individual behaviour and must be addressed at a societal level^{Footnote 6}.

Diabetes surveillance in Canada: How has the CCDSS evolved over time?

1997- National Diabetes Surveillance System (NDSS) Steering Committee formed
1999 - National Diabetes Surveillance System (NDSS) established
2003 - First report of the NDSS: Responding to the challenge of diabetes in Canada
2005 - The NDSS expands to the Canadian Chronic Disease Surveillance System (CCDSS) to include other chronic diseases
2010 - New conditions added to CCDSS
2019 - 20 years of diabetes surveillance using the CCDSS

Have rates of diabetes changed over time?

Between 2000 and 2016, the proportion of Canadians living with diabetes has increased by an average of 3.3% per year, but the rate of new cases has remained stable. Deaths among those with diabetes have decreased.

The CCDSS is updated annually and is supported by a pan-Canadian partnership between the Public Health Agency of Canada and all provinces and territories

See more at: Diabetes in Cananda data blog

Visit: Canada.ca and search 'Diabetes'
Get data: Canadian Chronic Disease Surveillance System Data tool
Follow us: @GovCanHealth
Like us: @HealthyCdns

Learn more about Diabetes in Canada

1

Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2018;42((Suppl 1):S1-S325).

Return to footnote 1 referrer

2

Canadian Chronic Disease Surveillance System (CCDSS), March 2019. Includes type 1 and type 2 diabetes combined, but excludes gestational diabetes. Aged 1+ years. Data from NS among individuals age 1-19 are excluded. Data from SK and NU were not available. Crude rates were based on randomly rounded counts to an adjacent multiple of 10. Mortality rate ratio was calculated by dividing the all-cause mortality rate among individuals with diabetes by the all-cause mortality rate among individuals without diabetes. A rate ratio greater than one indicates that individuals with the disease experience a higher mortality burden compared to individuals without, regardless of the cause of death.

Return to first footnote 2 referrer

3

Canadian Health Measures Survey, Cycle 5 (pre-diabetes includes Cycles 1-5 combined), June 2019. Aged 20-79 years. Pre-diabetes refers to someone who has a blood glucose level that is higher than normal but do not meet the criteria for a diagnosis of diabetes (6.0-6.9mmol/L). High blood glucose includes those with a blood glucose >=7.0mmol/L in a single fasted sample regardless of diagnosis status (excluding pregnant women).

Return to first footnote 3 referrer

4