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DIABETES FACTS

DIABETES IS A SERIOUS DISEASE

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Diabetes is associated with serious complications.
Diabetes is associated with significant morbidity, which results in increased healthcare costs, as well as decreased quality of life. The objectives of diabetes therapies are to prevent the onset and delay the progression of diabetes-related complications. Amongst people with diabetes:
  • 40% have diabetic retinopathy
  • 15% have foot ulcers
  • 80 – 90% have obesity
  • 34 – 45% have erectile dysfunction
  • 40– 50% have neuropathy
  • 40% have anxiety
  • 15% have depression
  • 75% of deaths will be due to coronary or cerebrovascular event
  • Have a 2- to 3-fold increased risk of coronary artery disease
Sources:
Public Health Agency of Canada. Diabetes in Canada: Highlights from the National Diabetes Surveillance System 2004–2005. 2008. Available at:http://www.phac-aspc.gc.ca/publicat/2008/dicndss-dacsnsd-04-05/index-eng.php.
Accessed June 15, 2011.

Canadian Diabetes Association Clinical Practice Guideline Expert Committee. Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2008;32 (suppl 1): S1-S201. Available at: http://www.diabetes.ca/for-professionals/resources/2008-cpg/.
Accessed June 15, 2011.

Statistics Canada. Sequelae of diabetes. Diabetic foot, chronic ICD-9 250.7. Available at: http://www.statcan.gc.ca/access_acces/archive.action?
loc=/pub/82-619-m/2005002/4144152-eng.htm.
Accessed June 15, 2011.
Diabetes is the leading cause of end-stage renal disease (ESRD)

Diabetes and ESRD in Canada (2010)

  • Diabetes was the leading cause of ESRD, identified in 35% of new cases.
  • The average age of incident hemodialysis patients was 65.3
  • More than half of these patients reported having diabetes.
  • Between 2001 and 2010, the prevalence rate of ESRD patients with diabetes as a primary diagnosis increased by 54%.
  • The lowest five-year survival rates in patients receiving dialysis were in those with renal vascular disease (36%), drug-induced renal failure (38%), and diabetes (39%).
Source:
Canadian Institute for Health Information. Canadian Organ Replacement Register Annual Report: Treatment of End-Stage Organ Failure in Canada: 2001-2010.
Diabetes is associated with higher mortality after cancer surgery
People with diabetes who undergo cancer surgery are more likely to die in the month following their operation that people who have cancer, but do not have diabetes. People with newly diagnosed cancers – especially colorectal or esophageal tumours – who also have type 2 diabetes had an approximately 50% greater risk of dying following surgery. While the reasons for this are not clear, it is possible that it could be due to the increased risk of infection and infection-related mortality associated with diabetes. Another possibility may be the increased risk of cardiovascular death associated with diabetes.

Source:
Barone BB, Yeh HC, Snyder CF, Peairs KS, Stein KB, Derr RL, Wolff AC, Brancati FL. Postoperative mortality in cancer patients with preexisting diabetes: systematic review and meta-analysis. Diabetes Care. 2010;33(4):931-939.
Diabetes is a strain on out-patient and in-patient resources.
  • Compared to people without diabetes adults with diabetes in Canada have twice as many visits to family physicians and 3 to 4 times as many visits to specialists.
  • Compared to people without diabetes, people with diabetes were hospitalized at higher rates for:
    • Heart failure: 4-fold increase
    • Stroke: 3-fold increase
    • Heart attack: 3-fold increase
    • Chronic kidney disease: 6-fold increase
    • Lower limb amputation: 19-fold increase
Source:
Public Health Agency of Canada. Report from the National Diabetes Surveillance: Diabetes in Canada 2009. Available at: http://www.phac-aspc.gc.ca.
Accessed June 15, 2011.

In the two years after their Canadian Community Health Survey 2000/2001 interview, 24% of the T2DM cohort were admitted to hospital. But not all members of the cohort were equally likely to have been hospitalized:
  • 34% of those aged 65 or older were hospitalized, compared with 12% of those aged 14 to 44
  • approximately one-third of those who lived in lower-income households were hospitalized vs. 16% of those in the highest household income quintile 
  • 54% of those who had been hospitalized in the year before the CCHS interview were admitted to hospital in the two years after the interview, compared with 19% who had no prior hospitalization
  • those who had never smoked were less likely than former or current smokers (19%, 27% and 25%, respectively) to be hospitalized.
Source: Ng E, McGrail KM, Johnson JA. Hospitalization risk in a type 2 diabetes cohort. Health Reports 2010:21(3) Available at http://www.statcan.gc.ca/pub/82-003-x/2010003/article/11326/findings-resultats-eng.htm Accessed June 15, 2011

A woman with type 2 diabetes has at 8 times greater risk of heart disease than a woman without diabetes.

Source: Laakso M et al. Does NIDDM increase the risk for coronary heart disease similarly in both low- and high-risk populations? Diabetologia. 1995;39:487-93.
Diabetes shortens life expectancy for all ages.
  • A 50-year-old with diabetes dies, on average, 6 years earlier than a counterpart without diabetes. (1)
  • Compared to people without diabetes, people with diabetes have higher mortality rates (2):
    • Age 20–44: 4 to 6 times higher
    • Age 45–79: 2 to 3 times higher
Sources:
  1. The Emerging Risk Factors Collaboration. Diabetes, fasting glucose, and risk of cause-specific death. N Engl J Med. 2011; 364:829-841.
  2. Public Health Agency of Canada. Report from the National Diabetes Surveillance: Diabetes in Canada 2009. Available at: http://www.phac-aspc.gc.ca. Accessed June 15, 2011.
In 2010, diabetes was the second most common reason for a physician visit in Canada.
Top 10 reasons* for patient visits to physicians in Canada, 2009
  1. Hypertension
  2. Diabetes (without complications)
  3. Health check-up
  4. Depression
  5. Anxiety
  6. Acute upper respiratory infection
  7. Normal pregnancy supervision
  8. Hyperlipidemia
  9. Esophagitis
  10. Hypothyroidism

* Based on ICD-9 classifications. Visits made to Canadian office-based physician – physicians maintaining an office outside hospitals

Source:
IMS Brogan. Canadian Disease and Therapeutic Index.
Available at: http://www.imshealth.com/portal/site/imshealth
/menuitem.a953aef4d73d1ecd88f611019418c22a/?vgnextoid=
94c0beb3a50d6110VgnVCM10000071812ca2RCRD
(Reproduced with permission) Accessed June 15, 2011.
Diabetes medications are among the most commonly prescribed drugs in Canada and in the world.
Top 10 dispensed therapeutic classes in Canada, 2010
Rank Therapeutic class Prescriptions dispensed in 2010 (in millions)
1 Cardiovasculars 77,130
2 Psychotherapeutics 64,853
3 Gastrointestinal/genitourinary 36,283
4 Cholesterol agents 34,214
5 Hormones 26,677
6 Analgesics 26,650
7 Anti-infectives 24,532
8 Diabetes therapies 22,773
9 Neurological disorders 21,434
10 Diuretics 17,835
* Estimated prescriptions dispensed in Canadian retail pharmacies. Includes new and refills.

Source:
IMS Brogan. Available at: http://www.imshealth.com/portal/
site/imshealth/menuitem.a953aef4d73d1ecd88f611019418c22a/
?vgnextoid=94c0beb3a50d6110VgnVCM10000071812ca2RCRD. (Reproduced with permission) Accessed June 15, 2011.

Top 10 therapeutic classes by worldwide sales, 2011
Rank Therapeutic class Sales (US$ billions) % sales
1 Oncologics 62.2 5.5
2 Respiratory agents 39.4 7.3
3 Antidiabetics 39.2 11.4
4 Lipid regulators 38.7 3.7
5 Antipsychotics 28.4 9.4
6 Angiotensin-II antagonists 27.4 -0.7
7 Anti-ulcerants 26.9 -6.4
8 Autoimmune agents 24.4 14.1
9 Antidepressants 20.4 -1.5
10 HIV antivirals 17.4 9.5
Total top 10   298.2 41
* Sales cover direct and indirect pharmaceutical channel purchases in US dollars from pharmaceutical wholesalers and manufacturers. The figures above include prescription and certain over-the-counter data and represent manufacturer prices.

Source:
IMS Brogan, MIDAS, December 2011. Available at: http://www.imshealth.com/portal/site/ims/menuitem.5ad1c081663fdf9b41d84b903208c22a/?vgnextoid=fbc65890d33ee210VgnVCM10000071812ca2RCRD Accessed January 22, 2013
Worldwide, diabetic retinopathy is responsible for almost 5% of cases of blindness due to eye disease

Worldwide, diabetic retinopathy is responsible for almost 5% of cases of blindness due to eye disease
Diabetic retinopathy is responsible for 4.8% of the 37 million cases of blindness due to eye diseases throughout the world (i.e. 1.8 million persons). After 15 years of having diabetes, about 2.0% of individuals will become blind, while about 10% will suffer severe visual loss. After 20 years, over 75% of people with diabetes will have some form of diabetic retinopathy. This eye disease can seriously compromise people's ability to work and live productive lives.

Source:
VISION 20/20 The Right to Sight. Diabetic Retinopathy. Available at http://www.vision2020.org/main.cfm?type=WIBDIEBETIC. Accessed June 15, 2011.

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Diabetes:
Did You Know…?

These facts paint a picture of the impact of diabetes on our health, healthcare system and economy.


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