More than 3 million Canadians have diabetes, and cases are growing at alarming rates. Do you know the warning signs?

About one in three Canadians don't realize that they're living with diabetes or are pre-diabetic.

Karen Hawthorne 6 minute read November 12, 2021
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In simple terms, diabetes happens when your pancreas doesn’t produce insulin or your body is resistant to insulin and can’t use it properly. (GETTY)

Chances are you know someone with diabetes, or you have it yourself. It’s that common.

The diagnosis can actually be a wakeup call to improve your health by eating more whole foods and increasing physical activity. And thanks to the discovery of insulin at the University of Toronto in 1921, people who develop diabetes have the benefit of a century of life-transforming innovation in the treatment of the disease.

Promising research shows that type 2 diabetes can be reversed with lifestyle changes, and in mice, the injection of new DNA molecules can potentially reverse new-onset type 1 diabetes.

But here’s the thing: The incidence of this disease is growing at alarming rates with kids under five the fastest group of newly diagnosed cases, and fewer than 50 per cent of Canadians are even aware of its often dire warning signs.

One in three may have diabetes
About 3.7 million Canadians have been diagnosed with the condition, a number that’s expected to rise to 4.8 million in the next decade. Many more may be unknowingly living with diabetes, and could go undiagnosed for years. In fact, Diabetes Canada estimates that one in three Canadians are unaware that they’re living with diabetes or are pre-diabetic.

There are serious health consequences when diabetes is left unmanaged, putting people at greater risk of kidney disease, eye damage and cardiovascular problems like stroke, heart disease and narrowing of arteries. Caught early, outcomes are much more favourable.

Distressing too, is the reported cost to the Canadian healthcare system. For 2021, the direct cost of diabetes and its associated health issues is estimated at $3.9 billion, and this is expected to be nearly $5 billion in the next decade.

The good news is that diabetes can be treated, and the physical consequences of this illness delayed — or, better yet, avoided — by altering diet, regular physical activity, reducing body weight, and quitting smoking.

The most common risk factors for diabetes? Being over the age of 45, being overweight or obese, living a sedentary lifestyle, a history of diabetes in the family, gestational diabetes which develops during pregnancy, high blood pressure, and heart disease or stroke.

Type 1 and type 2 diabetes
In simple terms, diabetes happens when your pancreas doesn’t produce insulin or your body is resistant to insulin and can’t use it properly. That’s a challenge because insulin is an essential hormone that controls the amount of glucose or blood sugar in your bloodstream, sending it to cells for energy.

Without it, you can experience hyperglycemia, or high blood sugar, which can cause vomiting, excessive thirst and hunger, a rapid heartbeat and vision problems.

As Diabetes Canada explains, type 1 is an autoimmune disease caused when your body’s immune system destroys its own insulin-producing cells in the pancreas. This leaves you reliant on external sources of insulin. Type 1 typically develops in children and youth — which is why it was once known as juvenile diabetes — but it can also occur with adults.

Type 2 diabetes is much more prevalent, accounting for 90 to 95 per cent of all cases. It was once described as adult-onset diabetes, although it’s now on the rise among children. Type 2 diabetes is classified as a metabolic disorder: people with the condition can’t metabolize food for vital processes in their body, either because the pancreas doesn’t produce enough insulin, or it can’t properly use the insulin created.

Gestational diabetes occurs in pregnant women. And while it usually resolves once the baby is born, it does increase the mother’s likelihood of developing type 2 diabetes later in life.

A cascade of symptoms
Get to know the signs: increased thirst and frequent or urgent urination are typical flags, because high blood sugar causes your kidneys to work overtime to rid your body of excess blood sugar. Fluids are pulled from other tissues which causes thirst.

Fatigue is another big one. Your body uses sugar or glucose for energy and when levels get too high, your body shifts into overdrive to expel the excesses, so you end up feeling tired.

High blood sugar levels also damage small blood vessels, and eyes are often the first place this damage is recognized; the result is blurred vision. As blood sugar levels wax and wane, vision can improve or worsen.

Blood vessel damage from diabetes also causes minor cuts and scrapes to take longer to heal. And because it’s harder for blood to reach wounds, these minor injuries are prone to infection and in extreme cases can lead to amputation.

Also, as your body works to expel high blood sugar, this can lead to increased hunger. And since glucose normally is used as energy at the cellular level, your body is left looking for alternative sources and tt begins burning or consuming fat and muscle, which leads to noticeable weight loss. Unexplained weight loss of 4.5 kg or five per cent of your body weight can be a warning sign of diabetes.

Nerves are also impacted by high blood sugar. This often presents itself in early stages as tingling or numbness, but can escalate to pain if left untreated. Skin can develop dark patches especially in the folds of the neck, near the underarm or groin, or appear raised and swollen.

Yeast, too, feeds off sugar — another symptom of diabetes is an increase of such infections in the mouth, armpits and genitals.

Insulin converts glucose into energy
When your metabolism is functioning properly, insulin balances blood glucose levels and when glucose levels get too, high excess glucose is stored in the liver until levels decrease. Typically, glucose levels decrease between meals, or when your body is stressed through physical demands like exercise and an extra boost of energy is required.

Type 1 diabetes can be managed by taking synthetic insulin through injections or a more advanced insulin injection pump. Type 2 is typically treated by insulin tablets or injections, or non-insulin medications like metformin.

Both types of diabetes require regimented monitoring to ensure blood sugar levels are stable. That’s the key, and also where healthy habits can make a difference. A healthy body weight, regular exercise and management of stress also lessen the severity of symptoms.

Disease management is critical
Many Canadians live long and healthy lives with diabetes, but management, healthy living and monitoring are essential.

Musician Neil Young has spent a lifetime entertaining around the globe while managing his type 1 diabetes. Former Prime Minister Brian Mulroney was diagnosed later in life, at 71, with a very rare blend of type 1 and type 2 diabetes. NHLer Max Domi, 26, the son of famous hockey player Tie Domi, was diagnosed at age 12 and went on to be a top draft pick. Two-time Stanley Cup champion, Bobby Clarke, was diagnosed as a pre-teen and is often heralded as the first superstar athlete to perform with type 1 diabetes.

If you have symptoms, get checked. You can also take Health Canada’s risk questionnaire.  Support and more information on living with diabetes can be found at Diabetes Canada, JDRF and Diabète Québec.