Diabetes in Canada | A Q&A with Dean Eurich

Dean Eurich is a professor in the School of Public Health and a researcher with the Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD) and the Alberta Diabetes Institute.  His research into diabetes-related health services, drug therapies and interventions has been directly translated into policy action and clinical practice guidelines for the management of diabetes around the world. 

Eurich‘s current research is focused on the systems and services for treatment and care of Indigenous Canadians with type 2 diabetes.

He answered some questions, giving a snapshot of diabetes in Canada. 

How common is diabetes in Canada? 

Diabetes affects about seven per cent of Canadians over the age of 12, and 20 per cent of adults over the age of 50 have diabetes. About 90 to 95 per cent of all diabetes cases are type 2. 

In Canada, Indigenous people are three to five times more likely to develop type 2 diabetes than non-Indigenous people. For example, of Indigenous people aged 60 to 65 years, 40 to 50 per cent have type 2 diabetes; this compares to 20 per cent of non-Indigenous people.  

What is the difference between type 1 and type 2 diabetes? 

Both are chronic diseases that affect the way your body regulates blood sugar, or glucose, with insulin. 

Type 1 diabetes is an autoimmune disease that attacks insulin-producing cells in the pancreas. It often appears and is diagnosed in childhood or early adulthood. Insulin is used as treatment.

People with type 2 diabetes don’t respond to the insulin their bodies make. It can be managed, and sometimes reversed, with nutrition, diet, exercise and medication. Insulin may become necessary if the disease progresses. 

Both type 1 and type 2 diabetes cause chronic high blood sugar levels that increase risk of other serious health complications. 

Why is type 2 diabetes more common, and why is the Indigenous population in Canada even more affected? 

Type 2 diabetes can be genetic or brought on by diet, inactivity and being overweight. As obesity rates rise, so does the rate of type 2 diabetes, making it a chronic disease of concern in Canada, and globally.  

Social factors also affect our health. This is often the case with Indigenous people who face historical and systemic barriers to achieving good health. For example, many Indigenous communities lack health services and screening programs, access to healthy traditional or affordable food, and adequate water and housing. 

Aside from the direct health implications these factors can increase stress which also contributes to type 2 diabetes. 

What is a misconception typically held about diabetes? 

A lot of people look at diabetes as a “sugar” disease, but it is much more than that. 

Diabetes-related complications include a high risk of cardiovascular problems such as heart attack and stroke, and kidney disease. It can cause nerve damage that may lead to infection and amputation. Damage to blood vessels in the eyes can affect vision and cause blindness. It can cause erectile and sexual dysfunction. 

Mental health is a major factor that contributes to the development of diabetes.  Once developed, the complications of diabetes can further affect mental health by causing stress and depression. 

Diabetes is a disease that affects quality of life. 

Insulin has been used to manage diabetes for 100 years. Given the current research into diabetes, what do you see as the next development in treatment or cure of the disease? 

The University of Alberta is leading research into transplanting islet cells—the cells of the pancreas that produce insulin that regulates blood sugar levels. An islet cell transplant can regenerate a pancreas that fails to produce insulin, curing type 1 diabetes. The University of Alberta is also leading the way in developing and testing of artificial pancreases – small devices implanted to regulate insulin and sugar levels.

When it comes to type 2 diabetes though, it can’t be easily fixed by the healthcare system which is focused on treatment. Rather, it will take an upstream, preventative approach to ensure everyone has equitable access to the resources it takes to achieve good health. Only through this approach will the tide of type 2 diabetes be lowered.

Learn more about Dean Eurich’s work at his seminar, Enhancing Diabetes Care with First Nations Communities, with the Alberta Diabetes Institute on May 4, 2021.