Less than a week after a study documented a startling rise in diabetes rates, the Health Council of Canada has issued recommendations aimed at promoting a “prevent it, find it, manage it” approach to primary health care.
The council, formed in the aftermath of the Romanow commission, says Canada needs to speed up changes in how health care is organized and delivered to people with chronic health problems such as diabetes.
“Promotion of healthy living to prevent chronic health conditions requires a strategic combination of public policy, targeted clinical care and a range of community-based campaigns to motivate people to change their eating and exercise habits,” states the 70-page report issued Monday by the council.
“Canada faces an unprecedented need for public investments in prevention.”
In terms of treating people already diagnosed with chronic health problems, the report says there’s strong evidence that delivering care through teams made up of nurses, pharmacists, nutritionists and doctors helps people with diabetes improve their blood sugar levels.
Yet, the report said “few Canadians have routine access to teams of health care professionals where they receive health care.”
As well, the recommendations said there should be electronic health records and support systems for patients to reduce the risk of complications.
“The way we provide health care today leaves too many people vulnerable to serious health problems that could be avoided,” Dr. Ian Bowmer, vice-chair of the Health Council of Canada, said in a statement.
“If we don’t support prevention and change the way we deliver care for chronic health conditions, we are not optimizing care and are putting the quality of life of Canadians at risk.”
The report urges programs be established to identify and target groups at risk for diabetes, citing the Kahnawake Schools Diabetes Prevention Program and a Latin American diabetes program in London, Ont.
Last week, a study by the Institute for Clinical Evaluative Sciences published in the Lancet said cases of diabetes have risen so dr?matically in Ontario that the proportion of adults with the disease has already surpassed the World Health Organization’s predicted global rate for a quarter-century from now.
The study found that in 2005, almost nine per cent of Ontarians over age 20 had diabetes, up from 5.2 per cent a decade earlier. Experts said the provincial figures mirror what is believed to be happening in the rest of Canada.
That almost 70 per cent jump means that diabetes among our population far exceeds the 6.4 per cent worldwide prevalence rate — and the 8.4 per cent rate for developed countries alone — projected by the WHO for 2030.
Source: The Canadian Press
People who suffer from stress or “job burn-out” may be almost twice as likely than others to develop type 2 diabetes.
A study carried out by a team of researchers at Tel Aviv University found that those who experienced job burn-out are 1.84 times more likely than others to develop the condition – even when factors like age, sex and obesity are taken into account,
The study of 677 mostly male, middle-aged workers also found that when the possible effect of blood pressure levels was eliminated, the risk was more than four-fold higher.
According to the researchers, their findings show that stress can be added to other factors such as high blood pressure, fat deposits around the waist and lack of exercise, which are all known to increase risk of developing type 2 diabetes, the most common form of the condition.
The study was published in the Psychosomatic Medicine journal.
It is well known that people with type 2 diabetes are at increased risk of pancreatic cancer, and now it seems that the risk extends to those with type 1 diabetes, researchers report. However, they point out that the risk is still very small.
Type 2 diabetes is associated with being overweight and is caused when the body becomes less responsive to the action of insulin, leading to high blood sugar levels. Type 1 diabetes arises, often in childhood, when the insulin-producing cells in the pancreas are damaged, usually by an aberrant immune reaction.
To assess the risk of pancreatic cancer in people with type 1 and young-onset diabetes, Dr. Richard J. Stevens and colleagues from the University of Oxford, UK, reviewed findings from nine population-based studies.
The likelihood of developing pancreatic cancer was twice as high in subjects with type 1 or young-onset diabetes as in people without diabetes, the team reports in the British Journal of Cancer.
This increased risk is similar in magnitude to that seen with type 2 diabetes.
There are many theories about the link between diabetes and pancreatic cancer, Stevens said in an interview with Reuters Health and “our results help narrow these.”
For example, he said, “they rule out a cancer-inducing role of the insulin-producing beta-cells in the pancreas, because in type 1 diabetes these cells have largely or entirely been destroyed.”
Stevens stressed that “people with type 1 diabetes should not be overly concerned about pancreatic cancer.” As he explained, “Pancreatic cancer is an extremely rare disease, and twice a tiny risk is still a tiny risk.”
People with diabetes “should remain focused on the common complications of diabetes such as heart disease, eye disease and kidney disease, and the many measures — including diet, exercise, and medication — that can be taken to avoid them,” Stevens concluded.
SOURCE: British Journal of Cancer, February 2007.