Thanks to the committee, and also thanks to Ms. Sidhu.
Diabetes Action Canada is a strategic, patient-oriented research network in chronic disease funded by CIHR and both public and private sector sponsors, including Diabetes Canada and JDRF.
Our mission is to develop patient- and research-informed innovations in equitable health systems, and policy designed to prevent diabetes and its complications.
Today I'm going to share some evidence with you. You've heard a lot of important information already, so I'm going to skip to the bottom line. Diabetes is the leading cause of blindness in working-age Canadians, the leading cause of disabling lower-limb amputation, the leading cause of kidney failure, and the highest risk for heart attacks and stroke. This is a devastating disease that requires lifelong self-management and access to the right care at the right time.
Diabetes more commonly affects vulnerable populations based on determinants of health. Some of these determinants are not modifiable. They are ethnic in origin or age-related. You've heard that there is a high risk in persons of Asian, South Asian, and African descent. Our indigenous people suffer three to five times the rate of diabetes compared to non-indigenous Canadians, and their risk of complications is even higher.
Many determinants, however, are modifiable, such as social and environmental conditions, particularly for indigenous peoples. Canadians in low-income brackets experience four times the risk of diabetes compared to those in high-income brackets. Working Canadians in lower-income brackets without drug benefits must choose between paying for rent and food, and purchasing medications necessary to treat their diabetes and other risk factors. Seniors with diabetes usually suffer many other chronic conditions. They are much more likely to be hospitalized in acute care and long-term care facilities that could be avoided with improved community-based treatment for their complex needs.
We know these facts. Why can't we address the vulnerabilities and prioritize health promotion and prevention of diabetes in Canada? The answer is not easy because to design and implement successful strategies we must activate those social and environmental determinants that support healthy lifestyles and overcome inequities. Access to affordable and healthy foods, and community support for improving physical activity will not be achieved through the health care system. These are major changes that require multiple levels of government, education, social service, and private sectors all working together for collective impact in preventing diabetes.
In addition, immediate changes to our health care system are urgently required to improve outcomes over the next decade. These changes must address the needs of persons living today with diabetes.
In 2015, our researchers conducted a national survey of persons with diabetes from the general population. They identified the fear of blindness, amputation, kidney failure, and, for those on insulin, the fear of low blood sugar that can actually cause death.
Now that Diabetes Action Canada has close ties with indigenous patient partners, we know that they are deeply concerned about the rising rates of diabetes among their youth. All have stated that they do not have access to the right care at the right time. They expect better communication with health-professional teams who understand their needs. They expect better support from community and government resources to improve their self-management of diabetes.
Across the globe, the best diabetes outcomes are reported by countries with digital health tracking systems instituted at regional levels. In Sweden, a national diabetes register tracks the personal health information of the entire diabetes population. The result is that Sweden has achieved some of the best diabetes outcomes in the world at a much lower cost than expended per capita in Canada. Therefore, a national diabetes strategy must include standardized, data-driven performance management of diabetes to track patient outcomes in communities. This will enable continual quality improvement based on best evidence.
In summary, Canada is long overdue for an effective national diabetes strategy that will guide the implementation necessary for effective health system and policy change. Diabetes Action Canada is poised to engage with all of our colleagues and yourselves in the development of this strategy.
Thank you.