Diabetes in Canada: Highlights from the National Diabetes Surveillance System, 2004-2005

Highlights of the NDSS

The National Diabetes Surveillance System

The National Diabetes Surveillance System (NDSS) is a network of provincial and territorial diabetes surveillance 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 has a broad stakeholder base including the federal and all provincial and territorial governments, non-governmental organizations, national Aboriginal groups, and researchers.

In each province and territory the health insurance registry database is linked to the physician billing and hospitalization databases to provide a rich data source on diabetes in Canada. The NDSS applied an updated case definition to this combined data source to extract the data. Individuals were included in the NDSS summary data set when they had at least one hospitalization with a diagnosis of diabetes or had at least two physician visits with a diagnosis of diabetes within a two-year period. The data were aggregated by age group, sex, and province and territory to protect an individual's privacy prior to being analyzed at the provincial, territorial, and national levels. The current national database includes summary information on individuals aged 1 year and older at the time of diabetes diagnosis, excluding cases of gestational diabetes, from all provinces and territories for the fiscal years 1995-1996 to 2004-2005.

Using administrative data for surveillance, as in the NDSS, often requires a compromise when trying to identify cases of a disease. It is necessary to balance the possibility of misclassifying people who actually have been diagnosed with diabetes but have not been identified by the NDSS as such (false-negatives) with the reverse where people who do not have diabetes but have been identified as having it (false-positives). Validation studies have indicated that the case definition used by the NDSS is reliable at minimizing 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. In addition to highlights from the NDSS, this report also showcases data from two special projects conducted with the Québec James Bay Cree and the British Columbia First Nations populations.

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