NDP urged to fund diabetes fight
Organization hoping figures compel new NDP government to increase funding
In its gloomiest report yet, Diabetes Canada says 29 per cent (1.4 million) of B.C.’s population either has diabetes or is at risk of getting it.
In the next decade, that proportion will grow to a third of the population if prevention efforts fail to curtail the trend, it warns.
The 20-page report is meant to sway the new NDP government to increase public funding of medications and devices. Nearly 500,000 B.C. residents have Type 1 or 2 diabetes and health costs associated with the condition are said to be $1 billion a year when accounting for what the taxpayer-funded health system expends and what patients pay in out-of-pocket costs.
In the past decade, the number of people diagnosed with the disease has increased by 74 per cent and the report projects that over the next decade diabetes will increase in prevalence by 44 per cent. An estimated 765,000 residents have pre-diabetes, a precursor to Type 2 diabetes in which blood glucose levels are abnormally high, it says. About half of those with pre-diabetes go on to get Type 2 diabetes.
“Diabetes has reached epidemic proportions in B.C.”, said Sheila Kern, regional director of Diabetes Canada.
Although B.C. is generally considered to be a healthier province than others due to lower rates of diabetes-triggering factors such as smoking, obesity and inactivity, the organization says the province’s growing populations in South Asian, Chinese and Aboriginal communities are driving the increase because such “ethnic-cultural groups are at a higher risk of developing Type 2 diabetes, compared to the general population.”
For many years, dietitians have warned diabetes rates are far higher in Indo-Canadian and other South Asian communities because of diets rich in butter and sugar.
Dr. Tom Elliott, a Vancouver endocrinologist and leading diabetes clinician, said aging and weight are the two biggest risk factors in all communities.
“Insulin cells die off as we age so the aging process is number one. And number two, we are getting fatter as a society,” he said, adding governments should provide more incentives to those who maintain healthy weight and fitness routines. Exercise improves blood sugar control, reduces insulin resistance, reduces blood pressure and controls weight.
“Nobody chooses to get diabetes or its complications but we should give some kind of credit to people who do the right things,” Elliott said.
He’s pleased the organization prepared the report “because the government needs this wake-up call.” He’s particularly critical of the B.C. government for not covering a new class of medications called SGLT2 inhibitors and even started a petition for coverage.
B.C. is the only jurisdiction in Canada that does not provide some coverage for such medications.
But Dr. Tom Perry, a Vancouver internist and clinical pharmacologist with the Therapeutics Initiative, said before governments commit to large investments in new medications, more research is needed to show the best treatments for Type 2 diabetes (which affects 400,000 B.C. residents). A few months ago, the TI told doctors in a boldly written bulletin that they should focus on prescribing lifestyle modifications to patients instead of medications.
“We have built a huge boondoggle superstructure to support frequent medical visits, multiple specialist consultations with dietitians and nurses, without any proof of whether this is really useful or worth the costs,” he said.
“It has all diverted attention away from poor diets and lack of exercise, the cardinal drivers of the epidemic,” Perry said, noting the greater the focus on medications, the less there is on lifestyle changes, especially research comparing lifestyle- and diet-oriented treatment versus drug treatment.
Kern said although the report was completed before the provincial election, it is being released now because “the political situation presented an opportunity here.”
B.C.’s premier-designate John Horgan has not yet named his health ministers (including a new cabinet position for mental health). Judy Darcy was the opposition health critic and is considered a front-runner for the cabinet post. On Tuesday, Darcy said she saw a brief summary of the diabetes report and agrees diabetes is at epidemic levels.
“The numbers are steadily increasing. It’s staggering and worrisome. We need an aggressive, coordinated strategy,” she said.
The NDP election platform pledged expanded coverage for insulin pumps beyond age 25, but didn’t cost it out. Alberta covers the $7,000 devices for all ages, as does Ontario. But the devices have to be replaced every four or five years.
Diabetes Canada received an unrestricted grant from the pharmaceutical company, Novo Nordisk, to offset costs of the report preparation. The company is listed as giving $400,000 to Diabetes Canada in 2016.
According to Diabetes Canada’s website, it had $50 million in revenues last year, including large sums from drug and device companies.