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More Canadians Than Ever Before Now At Risk

According To New Guidelines Launched By Canadian Diabetes Association

New scientific Guidelines emphasize early identification and aggressive management of diabetes

TORONTO, Ontario (September 18, 2008) ? In addition to the more than 2.4 million Canadians currently affected by diabetes, up to six million more have prediabetes putting them at an increased risk for developing diabetes and its complications. If left untreated, approximately 25 per cent of people with prediabetes will progress to diabetes within three to five years.  Prediabetes is a relatively new term for impaired glucose tolerance, or blood glucose levels that are near but not quite at the level that defines a diabetes diagnosis.

New clinical practice guidelines released today by the Canadian Diabetes Association emphasize the early identification of risk factors in the prediabetes stage in order to prevent the onset of diabetes and the aggressive management of those risk factors in order to prevent the serious complications associated with the disease, including heart disease.

"Research has shown that long-term damage to the body, especially the heart and circulatory system, may already be occurring before a diabetes diagnosis," says Ellen Malcolmson, President and CEO, Canadian Diabetes Association. "The good news is that for those at risk of type 2 diabetes, a diagnosis may be prevented if the warning signs are identified early. We are encouraging Canadians to take a more active role in their health and ask their doctor about their own risk for developing diabetes and its complications. For those who have diabetes, if they take action now to manage the disease, through healthy meal planning, physical activity, smoking cessation, and medication when required, they may delay or even prevent the serious complications associated with diabetes."

The 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada (the Guidelines) are internationally recognized as comprehensive and evidence-based guidelines, incorporating revised recommendations for the care of Canadians living with diabetes, as well as preventative measures for populations at high risk of developing type 2 diabetes.

The Expert Panel committee responsible for the development of the Guidelines includes 99 volunteers representing a broad variety of healthcare professionals from across the country. A number of new chapters have also been added to the Guidelines, widening the scope to address emerging research in diabetes-related care. Healthcare professionals are encouraged to incorporate the Guidelines into their daily practice as they offer strategies to help Canadians with diabetes live longer, healthier lives.


Cardiovascular disease, including heart disease and stroke are the most common, most serious complications associated with diabetes.  The unfortunate reality is that up to 80 per cent of people with diabetes will die from heart disease. 

In an effort to reduce the risk for serious complications, including heart disease, the Guidelines recommend a multifaceted, comprehensive approach to diabetes management, which includes healthy meal planning, physical activity, smoking cessation and tight control of important targets, such as blood pressure, cholesterol and blood glucose levels. Furthermore, the Guidelines now provide clinicians with more information on how to best screen people with diabetes for cardiovascular risk. Research has proven that the risk of heart disease can be reduced by more than 50 per cent through a combination of lifestyle approaches and medications that protect against cardiovascular disease.


Prediabetes is becoming increasingly more common worldwide. In addition to increasing someone?s risk of developing diabetes, prediabetes also increases one?s risk of developing cardiovascular disease. 

The Guidelines define prediabetes as a fasting plasma glucose (FPG) level of 6.1 to 6.9 mmol/L or presence of impaired glucose tolerance on a 75-gram oral glucose tolerance test (OGTT). For those individuals with an FPG level between 5.6 and 6.0 mmol/L and one or more risk factors for diabetes, the Guidelines recommend performing an OGTT.  Risk factors for type 2 diabetes include: family history of diabetes, being a member of a high risk population, existing complications associated with diabetes (e.g., eye, nerve or kidney problems), having heart disease, high blood pressure, a history of gestational diabetes and being overweight.

The good news is that many people who fall into the prediabetes stage can delay or prevent the development of type 2 diabetes with lifestyle changes and if required, medication. Studies have shown that through lifestyle changes, including moderate weight loss and regular exercise, the onset of type 2 diabetes can be delayed by up to 58 per cent.


In addition to being a chronic, incurable disease, diabetes dramatically increases the risk of severe health complications such as heart attack, stroke, kidney failure, limb amputation and blindness.  A leading cause of death by disease, Canadian adults with diabetes are twice as likely to die prematurely, compared to persons without diabetes.

For those with diabetes, select recommendations from the Guidelines announced today include:

  • Early identification and treatment of risk factors for diabetes-related complications:  The majority of people with diabetes are at risk of associated health conditions and complications, such as cardiovascular disease, kidney and eye disease. Through proper disease management and identification of early warning signs, serious complications can be prevented.
  • Achieving tight control of blood pressure and cholesterol: The Guidelines are now recommending that people with diabetes who are at risk for developing heart disease be aggressively treated to lower LDL or "bad" cholesterol to equal to or less than 2 mmol/L. This lower level, in combination with strict blood pressure control, is proven to help substantially reduce two of the most prevalent diabetes complications ? heart disease and stroke.
  • Improve self-management through increased physical activity in combination with better nutrition and weight control.
  • Increase resistance exercise: People with diabetes are encouraged to perform resistance exercises in addition to moderate to vigorous aerobic exercises, such as brisk walking. Physical activity is a key ingredient to living a longer, healthier life and can result in better blood glucose control in people with type 2 diabetes.

Reduce fat intake: Adults with diabetes should consume no more than seven per cent of total daily energy from saturated fat and should limit intake of trans fatty acids to a minimum.

"The Guidelines provide clinicians with detailed information about how to best manage diabetes, with a large focus on the prevention and management of the serious complications associated with diabetes, particularly heart disease," says Dr. Gillian Booth, Chair, Methods, Expert Committee for the 2008 Clinical Practice Guidelines, Assistant Professor, Department of Medicine, University of Toronto.  "The reality is more and more Canadians are being faced with diabetes and its complications, which means that healthcare professionals and people with diabetes need to work closely together to identify risk factors for diabetes early, and to manage other risk factors as quickly as possible after diagnosis to reduce the risk of serious and deadly complications."

The Canadian Diabetes Association is pleased to announce an exciting partnership with Shoppers Drug Mart that will provide additional resources to Canadians affected by diabetes. The first of these resources will be available in Shoppers Drug Mart stores starting November 2008. All materials will be compliant with the Canadian Diabetes Association?s 2008 Clinical Practice Guidelines.


The Canadian Diabetes Association works in communities across the country to promote the health of Canadians and eliminate diabetes through our strong nationwide network of volunteers, employees, healthcare professionals, researchers, partners and supporters. In the struggle against this global epidemic, our expertise is recognized around the world. The Canadian Diabetes Association: setting the world standard. To learn more, visit diabetes.ca or call 1-800-BANTING (226-8464).


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