When it comes to chronic diseases, the triumvirate of diabetes, kidney disorders and cardiovascular diseases is the Bermuda triangle that takes more lives than any other group of conditions. The causal relationships are complex and the variables at play are many, but between these three, for a substantial number of Canadians, the first to grab hold is diabetes. Public Health Agency of Canada figures from 2011 put the number of Canadians with diabetes at 2.4 million, but perhaps more alarming is the change in disease prevalence, increasing more than two fold over the past decade. A recent paper published in the Canadian Medical Association Journal authored by the Libin Cardiovascular Institute of Alberta’s Tanvir Chowdhury Turin, PhD revealed that the lifetime risk of developing diabetes for Albertans is 50%. The projection is that five in 10 young Albertans will develop diabetes if they are followed through their remaining lifetime.
To put this within the cardiovascular disease frame, what we know is that over two-thirds of people age 65 or older with diabetes die from some form of heart disease. People with diabetes are >3 times more likely to develop cardiovascular diseases. That means for large portions of the population, to prevent or slow the development of heart disease, we need to look at diabetes.
“Unfortunately, diabetes is a condition that is difficult if not impossible to roll back. Once you’re on that train, it is a matter of management and slowing progression into broader vascular diseases. So the realities of these lifetime risk numbers are quite alarming. We did this study from the need to communicate the risk towards the general public and policy makers in an easy understanding manner so that they comprehend the severity of the diabetes burden we are facing.” says Chowdhury.
As with most conditions, some seem more impacted than others, and parsing the data is an important step towards identifying a path out. Chowdhury’s paper revealed that First Nations populations have a higher lifetime risk of diabetes, and whereas with the population overall the risk is greater in men, the opposite is true within this group. The disease burden is consistent with previous evidence that indicates a higher incidence and prevalence of diabetes among First Nations people in population-based studies.
“A host of elements can be at play when looking at different subgroups of our population, and we have seen a number of studies in the cardiovascular realm highlighting, for example, higher cardiovascular risks within south Asian populations,” says Chowdhury. “Bringing out this type of information with as many subtleties as possible is important in defining further research questions, and at the end of the day laying out a thoughtful plan to combat population-level health challenges that are of concern to everybody.”