The diabetes data presented in this chapter are based on the broad definition of diabetes (i.e., diabetes mellitus).

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1 Diabetes HIGHLIGHTS In 23, 14% of seniors living in Peel reported that they had diabetes, as diagnosed by a health-care professional. Hospitalization rates for diabetes increased by age up to 79 years of age for both females and males in Peel, although the highest age-specific rate was among males 85 years of age and older. In Peel, diabetes was the fourth leading cause of death among male seniors and the fifth leading cause of death among female seniors in 21. Introduction Diabetes is a chronic condition that has no cure and is a leading cause of death in Canada. There are three types of diabetes (type 1, type 2 and gestational); however, type 2 is the most common. Type 2 diabetes occurs when the pancreas does not produce enough insulin or when the body does not effectively use the insulin that is produced. Nine out of 1 people with diabetes have type 2 Diabetes. 89 If left untreated or improperly managed, diabetes can result in a variety of complications, including: heart disease, kidney disease, eye disease, problems with erection (impotence), and nerve damage. 89 The first step in avoiding the onset of these complications is recognizing the risk factors, as well as signs and symptoms that may indicate a person has diabetes. Careful management of diabetes, for those living with it, can delay or even prevent complications. 89 Age (specifically 4 years and older), in addition to obesity, having a parent or sibling with diabetes, and high blood pressure are all risk factors for developing diabetes. Of all these risk factors, obesity is modifiable through diet and exercise. 89 The diabetes data presented in this chapter are based on the broad definition of diabetes (i.e., diabetes mellitus). Prevalence of Diabetes In 23, 14% of seniors living in Peel reported that they had diabetes * as diagnosed by a health-care professional. This result is similar to Ontario. * Data should be interpreted with caution due to high sampling variability. The Regional Municipality of Peel 147

2 Emergency Department Visits for Diabetes In 23, there were 266 emergency department visits among Peel seniors for diabetes. The rates for emergency department visits increased by age up to 89 years of age for males and up to 84 years of age for females (see Figure 12.1). Figure 12.1: Emergency Department Visits for Diabetes by Age Group and Sex, Region of Peel, 23 Male Female 9 Number of visits per 1, seniors NR=Not releasable due to small numbers. Sources: National Ambulatory Care Reporting System Data 23. Provincial Health Planning Database (PHPDB) Extracted: [November 25], Knowledge Management and Reporting Branch, Ontario Ministry of Population Estimates , Provincial Health Planning Database (PHPDB), release date: March 25, Knowledge Management and Reporting Branch, Ontario Ministry of Age group (years) NR Hospitalization for Diabetes Hospitalization rates for diabetes decreased among seniors between 1995 and 2 in both Peel and Ontario; however, the rates have been relatively stable between 2 and 23 (see Figure 12.2). 148 Seniors Health Report 26

3 Figure 12.2: Hospitalization for Diabetes by Year, Region of Peel and Ontario, Number of hospitalizations per 1, seniors Note: The line between 22 and 23 represents ICD coding changes for hospitalization data from ICD-9 (prior to 23) to ICD-1-CA (23). Sources: Hospital In-Patient Data , Provincial Health Planning Database (PHPDB), Health Planning Branch, Ontario Ministry of Population Estimates , Provincial Health Planning Database (PHPDB), release date: March 25, Knowledge Management and Reporting Branch, Ontario Ministry of Peel Ontario Year Hospitalization rates for diabetes generally increased by age up to 79 years of age for both females and males in Peel, although the highest age-specific rate was among males 85 years of age and older (see Figure 12.3). Figure 12.3: Hospitalization for Diabetes by Age Group and Sex, Region of Peel, Number of hospitalizations per 1, seniors Male Female Age group (years) Sources: Hospital In-Patient Data 23, Provincial Health Planning Database (PHPDB), Health Planning Branch, Ontario Ministry of Population Estimates , Provincial Health Planning Database (PHPDB), release date: March 25, Knowledge Management and Reporting Branch, Ontario Ministry of Health and Long-Term Care. The Regional Municipality of Peel 149

4 Mortality from Diabetes Throughout the province of Ontario, mortality rates for diabetes have increased among seniors since Mortality rates for Peel have fluctuated over time (see Figure 12.4). In Peel, diabetes was the fourth leading cause of death among male seniors and the fifth leading cause of death among female seniors in 21 (see Appendix 3). Figure 12.4: Mortality from Diabetes by Year, Region of Peel and Ontario, Number of deaths per 1, seniors Note: The line between 1999 and 2 represents ICD coding changes for mortality data from ICD-9 (prior to 2) to ICD-1-CA (2 and beyond). Source: Ontario Mortality Database , HELPS (Health Planning System), Public Health Branch, Ontario Ministry of Population Estimates , Provincial Health Planning Database (PHPDB), release date: March 25, Knowledge Management and Reporting Branch, Ontario Ministry of Peel Ontario Year In 21, the mortality rates for diabetes increased by age for male and female seniors in Peel (see Figure 12.5). 15 Seniors Health Report 26

5 Figure 12.5: Mortality from Diabetes by Age Group and Sex, Region of Peel, 21 9 Number of deaths per 1, seniors Male Female NR Age group (years) 45.5 NR=Not releasable due to small numbers. Sources: Ontario Mortality Database 21, HELPS (Health Planning System), Public Health Branch, Ontario Ministry of Health and Long-Term Care. Population Estimates , Provincial Health Planning Database (PHPDB), release date: March 25, Knowledge Management and Reporting Branch, Ontario Ministry of Health and Long-Term Care. The Regional Municipality of Peel 151

6 Summary In 23, 14% of seniors living in Peel reported that they had diabetes as diagnosed by a health-care professional. A similar finding occurred in Ontario. The rates of emergency department visits for diabetes increased by age up to 89 years of age for males and up to 84 years of age for females. Hospitalization rates for diabetes decreased among seniors between 1995 and 2 in both Peel and Ontario; however, the rates have been relatively stable since the year 2. Hospitalization rates for diabetes increased by age up to 79 years of age for both females and males in Peel, although the highest age-specific rate was among males 85 years of age and older. Throughout the province of Ontario, mortality rates for diabetes have increased among seniors since Mortality rates for Peel have fluctuated over time. In Peel, diabetes was the fourth leading cause of death among male seniors and the fifth leading cause of death among female seniors in 21. The mortality rates for diabetes increased by age for males and females. 152 Seniors Health Report 26