Living well

Understanding the causes and treatments of diabetes

November is Diabetes Awareness Month, a disease that, including prediabetes, affects one in three Canadians. While the cause of diabetes varies by type, all forms lead to excess sugar (glucose) in the blood, which can cause health problems, including blindness, heart disease and kidney disease.

Research shows that non-First Nations Canadians 20 years of age today face a 50% chance of developing diabetes in their lifetime, with a higher rate (80%) for First Nations Canadians. The best-known types of diabetes are type 1 and type 2, but there are others.

“Most Canadians should be tested for diabetes starting at age 40, or earlier if there are risk factors such as a family history of diabetes or your body shape and size,” says Diabetes Canada (diabetes.ca) spokesperson and Costco member Dr. Harpreet Bajaj, an endocrinologist who treats adult diabetes patients in Brampton, Ontario.

Costco member Lori Robinson was diagnosed with type 1 diabetes at age 11 in 1980. She learned early on how to manage her diabetes with daily insulin injections, blood sugar monitoring, healthy eating and exercise. “I’ve learned moderation and balance,” she tells the Connection.

Diabetes types

Type 2. The most common diagnosis accounts for 90% to 95% of cases. People with type 2 can’t properly use the insulin made by their bodies, or their bodies aren’t able to produce enough insulin. Mostly developed in adulthood due to increasing insulin resistance related to being overweight and inactive, type 2 diabetes can sometimes be managed with healthy eating and regular exercise but may also require medication or insulin therapy.

Type 1. The second most common diagnosis is an autoimmune disease also known as insulin-dependent diabetes. People with type 1 diabetes aren’t able to produce their own insulin (and therefore can’t regulate their blood sugar) because their immune system is attacking their pancreas. Roughly 10% of people living with diabetes have type 1, and they are usually diagnosed as children or young adults. They will need to inject insulin or use an insulin pump daily for the rest of their lives.

Prediabetes. Prediabetes is a condition in which blood sugar levels are higher than normal but not high enough to be diagnosed as type 2. “There are no symptoms initially, which is why screening is important,” says Bajaj. If prediabetes is left unmanaged, the risk of developing type 2 diabetes increases. The good news? With healthy lifestyle changes, prediabetes is reversible.

Gestational diabetes. Gestational diabetes is a temporary form of diabetes that occurs during pregnancy; between 3% and 20% of pregnant women develop it. This diagnosis may increase the risk of developing diabetes later in life for both mother and child.

Treatment options

Lifestyle changes and diabetes drugs or insulin are the first steps in regulating blood sugar levels. If medication is required, Diabetes Canada recommends metformin. It is used to treat type 2 diabetes—along with lifestyle changes—and prediabetes, as it reduces the amount of sugar produced in the liver and helps with weight loss. For those with type 2 diabetes who have obesity issues, weightloss surgery, such as gastric bypass, may be an option.

Advances in treatment have made managing diabetes easier. In 2018, Robinson began using a continuous glucose monitor, a wearable device that tracks blood glucose, allowing her to check her readings by waving her iPhone over the monitor’s sensor. “It has been transformative,” she says.

“We’ve come a long way since insulin was discovered in Canada in 1921,” says Bajaj. “Over the past 50 years, there has been a lot of progress with new medications. And technology is also playing a big part in improving diabetes management.”

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