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, ON Sept. 18 /CNW/ - In addition to the more than 2.4 million
Canadians currently affected by diabetes, up to six million more have
prediabetes(1) 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.(2)
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
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.(3) The
unfortunate reality is that up to 80 per cent of people with diabetes will die
from heart disease.(4)
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.(5)


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.(6)
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.(7)
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.(8)


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.(9) A leading cause of
death by disease, Canadian adults with diabetes are twice as likely to die
prematurely, compared to persons without diabetes.(10)
For those with diabetes, select recommendations from the Guidelines
announced today include(11):


  • 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
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

About Canadian Diabetes Association

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 or
call 1-800-BANTING (226-8464).