Who Gets Diabetes?

In Canada, 1.8 million people have been diagnosed with diabetes, and up to another half million do not yet know they are living with type 2 diabetes. Among Aboriginal people, the rate is three times higher than for the general population. Diabetes is the seventh leading cause of death in Canada. Eighty percent of people with diabetes will die from a heart attack or stroke. Diabetes is the leading of cause of kidney failure, blindness and limb amputation in Canada today. In the United States, more than 17 million people have diabetes and 200,000 people die prematurely from diabetes every year. Worldwide, there are more than 240 million people with diabetes. By 2016, more than 3 million Canadians will be living with diabetes, and there will be more than 300 million around the world.

Groups at Most Risk for Getting Diabetes

People with close relatives who have diabetes
Aboriginal Peoples
People from Asia, South-East Asia, Latin America or Africa
People over 40 years of age
People who have high blood pressure, high cholesterol levels or other fats in their blood
People who have had gestational diabetes or given birth to a baby that weighed more than 4 kilograms (9 pounds)
People who are new to Canada (immigrants and refugees)
People who have been diagnosed with prediabetes
People who have some types of disabilities

Among people with disabilities, some disability groups face specific challenges that raise their risk of getting type 2 diabetes. These challenges can be related to changes in body functions or they may result from social and physical barriers to supports and services. There has been little research about the links between diabetes and disability, but some researchers have started to pay attention. There are signs that people who have spinal cord injuries (paralysis), people with learning disabilities, people with intellectual disabilities and people with mental health difficulties are at a higher risk of getting type 2 diabetes than people with other types of disabilities. However, there is still a lot that is not known about the links between different kinds of disability and diabetes or the reasons for such links. Here is some of what is known:

Disability Groups with a High Risk for Developing Type 2 Diabetes

People who have a spinal cord injury are at high risk of developing type 2 diabetes because the injury affects the whole body and all of its systems and can increase the body’s resistance to insulin. People who have a spinal cord injury tend to have more fat and less muscle in their bodies, and they also burn fewer calories. This may change the way that their bodies use insulin. Spinal cord injury also tends to lower peoples’ physical activity levels, which can also affect insulin production. People who have lived with their spinal cord injury for 10 or more years may get prediabetes or develop type 2 diabetes, and the older they get, the higher their risk goes. People with spinal cord injuries may also show the effects of aging early, increasing their risk of getting type 2 diabetes.

People who have a vision or hearing impairment are at risk of developing type 2 diabetes due to problems getting information about health issues like diabetes. People who cannot access print information are excluded from many sources of health information, and people who are Deaf or hard-of-hearing cannot just walk into an emergency department or clinic and expect to receive services in ASL. People with low vision or blindness can have difficulty getting out of the house and being physically active. Stigma against Deaf persons or lack of communication aides can keep people with hearing loss out of community centres and services that offer information about health issues like diabetes sports and recreation programs.

People who have an intellectual disability can have limited ability to care for themselves, making them a high risk for developing type 2 diabetes. They may also live in places where they do not have a lot of control over what they eat or their day to day lives. There may be limited services and programs to help them lead active, healthy lives. Stigma against people with intellectual disabilities, and popular assumptions about their capacity, can also limit their opportunities to learn and work, and to afford healthy food.

People who have mental health issues can have difficulty following healthy routines and some of the drugs used to treat psychiatric conditions can make them more likely to develop diabetes. They may also lack the resources needed to take care of their health. Research indicates that health care providers may overlook the physical health concerns of people who have a psychiatric disability as they focus on the mental health issues. People with mental health issues may not have the self confidence to challenge doctors when they are worried about their health. Stigma toward mental illness can isolate people, which may also reduce their ability to be physically active and eat healthy.

People who have learning disabilities may also be more likely to develop type 2 diabetes because their physical health concerns may be seen as part of the learning disability. They may also face difficulties finding and using information about health issues. Low self esteem may lower their motivation to look after their overall health needs.

Seniors who have disabilities carry a very high risk of developing type 2 diabetes. The risk of getting type 2 diabetes increases rapidly over the age of 40, and treatment of diabetes in seniors is often complicated by the many health issues that develop due to aging. People with certain types of disabilities (for example, spinal cord injury) can show the effects of aging early, increasing the risk of developing type 2 diabetes.

While it is clear that people who have disabilities face issues and life circumstances that may put them at greater risk of getting type 2 diabetes, more research is needed on the links between disability and diabetes. Because research on diabetes and disability is not complete, every person with a disability should take the risk of developing type 2 diabetes seriously.

Diagnosing Diabetes
A diagnosis of diabetes must be made by a doctor.
Diabetes is diagnosed by measuring the amount of sugar (glucose) in your system. A doctor will test you for diabetes if you report that you are having symptoms of the disease, or if you are overweight or have other signs that you are at risk for diabetes. If you have family members who have diabetes, you should ask your doctor to monitor you for diabetes. Anyone over the age of 40 should have an impaired fasting glucose test every three years, and if you have any of the risk factors for type 2 diabetes, you should be screened more often.