The impact of diabetes on Manitoba health care

Hey there, time traveller!
This article was published 19/04/2024 (566 days ago), so information in it may no longer be current.

The impact of diabetes on individuals and its cost to our health-care system are so large that Manitoba will never have a financially sustainable health-care system without doing a much better job of preventing Type 2 diabetes.

Recent studies suggest caring for individuals with diabetes may contribute as much as one-quarter of all health-care costs. Preventing diabetes is a potent game changer. Imagine preventing diabetes in Manitoba to the extent that $5 billion in treatment costs are saved over the next 10 to 15 years, with these funds then allocated to the overall upgrading and availability of health care for all Manitobans!

In 1996, Type 2 diabetes was declared an epidemic in Manitoba, yet it has never been treated with the same seriousness as infectious epidemics. The impact of diabetes in the 28 years since then has been longer and larger than the COVID-19 pandemic. A recent study from seven Toronto hospitals found 28 per cent of admitted patients had diabetes, a far higher proportion than the approximately 10 per cent of the population with the condition.

Effectively preventing diabetes means more bed space in hospitals, shorter emergency room wait times, healthier Manitobans, a more productive workforce and a financially sustainable health-care system.

You don’t have to imagine this as an unfounded possibility. The Manitoba government estimated preventing 200 new cases of diabetes saves the province’s health-care system $1 million in the first year. In 2015, the approximately 9,000 people newly diagnosed with diabetes that year added $45 million in new provincial health costs.

When almost 9,000 Manitobans were newly diagnosed with diabetes in 2016, the year had to include the continuing costs of those diagnosed in previous years as well as for those newly diagnosed. Like compounding interest, the costs rise each year.

When diabetes was declared an epidemic in Manitoba in 1996, there were just over 46,000 people with diabetes in our province.

This year, the number is expected to be about 150,000.

If, starting in 1996, major action had been taken to prevent diabetes to the extent that the number of cases had been kept at 46,000 each year — with new cases being balanced by deaths of those with diabetes — then the total health system costs saved from 1996 to today would be $5 billion or more.

It is easy to see why preventing Type 2 diabetes should be at the top of Manitoba’s health agenda. Sadly, in the years since 1996, it has not been.

Surprisingly, on the government’s A to Z of more than 120 health-care issues for Manitoba as listed on its website, diabetes is not even included.

Some might say it is impossible to do better at preventing diabetes than we are doing. This view is wrong. Evidence to prevent 60 per cent of new cases in individuals was available by the year 2000. Translating this knowledge to prevent diabetes in communities (whether geographic or ethnocultural communities) should have been at the top of the agenda. Since 2000, our knowledge of factors associated with an increase or decrease in diabetes risk has improved substantially. Our ability to prevent it should now be much better.

What can we do? The government should have a major well-funded effort to prevent Type 2 diabetes and it should embark on a focused effort to work with communities to determine best practices in translating knowledge of diabetes prevention from individuals to communities.

The initial emphasis should be in communities with the highest prevalence of diabetes. It is important not just to prevent diabetes, but also to prevent complications. As Manitobans we also need to learn from First Nations communities which have used effective innovations. As an example, the NUKA approach being used in the Opaskwayak Cree Nation has been successful in improving care and in reducing the cost of transporting individuals with diabetes out of their home community.

For many years I have called for more attention to preventing diabetes. Surely it is time for action.

The province and Manitoba’s chief public health officer should take specific actions. The Diabetes 360 plan from Diabetes Canada recommends achieving 90 per cent of Canadians living in an environment that preserves wellness and prevents the development of diabetes, 90 per cent of Canadians being aware of their diabetes status, 90 per cent of Canadians living with or at risk for diabetes engaged in appropriate interventions to prevent diabetes and its complications and 90 per cent of Canadians engaged in interventions achieving improved health outcomes.

The government of Manitoba should deliver on these outcomes, and do more than this. A major effort has been made to indicate in restaurants whether specific foods promote heart health. A similar effort should be made for diabetes. The public health effort in Manitoba needs to be reinforced by substantial funding for research specific to Manitoba communities.

Until we succeed in dramatically reducing new cases of diabetes and its complications, we are unlikely to achieve a financially sustainable high quality health-care system. I call on the Manitoba government to be bold and to take urgent action. The health of all Manitobans is at stake.

Jon Gerrard is a former MLA for the district of River Heights.